The comparative analysis of methods of evaluation of cognitive dysfunction in peri-operational period in patients of elder age after endoprosthesis replacement of hip and knee joints


如何引用文章

全文:

详细

The postoperative cognitive dysfunction significantly decreases quality of life, contributes to disability and increases risk of death. Notwithstanding of that, there is no precise criteria and common techniques of diagnostic of postoperative cognitive dysfunction. The study was organized to analyze validity of techniques of fast evaluation of cognitive status in diagnostic of postoperative cognitive dysfunction in patients after endoprosthesis replacement of large joints of lower extremities. The sampling included 41 patient older than 65 years and underwent operation of endoprosthesis replacement of lower extremities. The patients were applied neuropsychologic tests using MoCA and MMSE scales. The full value examination was implemented using word drill test, drawing links test, Stroop test, words encoding test, frontal dysfunction scale. The full value examination of cognitive functions were passed only by 15 patients (36.6%) with initially higher level of cognitive functionality. All the rest patients refused lasting evaluation and were evaluated according Montreal Cognitive Assessment (MoCA) and Mini-mental state examination (MMSE) scales. The postoperative cognitive dysfunction was diagnosed in 7 patients (17%). The results of full value examination were comparable with the results of short estimation according MoCA scale (r=0.84, p<0.05). The most of patients (85.7%) among those who developed postoperative cognitive dysfunction had mild cognitive impairments in pre-operative period. The mild cognitive impairment is a risk factor of post-operative cognitive dysfunction. The application of lasting survey is linked with high percentage of refusals that can artificially underrate morbidity of postoperative cognitive dysfunction.

作者简介

Mikhail Politov

The I.M. Sechenov first Moscow medical university of Minzdrav of Russia

Email: politov.mikhail@gmail.com
assistant Professor 119991, Moscow, Russia

A. Shteinmetz

The I.M. Sechenov first Moscow medical university of Minzdrav of Russia

119991, Moscow, Russia

M. Krasnoselskiy

The I.M. Sechenov first Moscow medical university of Minzdrav of Russia

119991, Moscow, Russia

S. Bastrikin

The I.M. Sechenov first Moscow medical university of Minzdrav of Russia

119991, Moscow, Russia

E. Bulanova

The I.M. Sechenov first Moscow medical university of Minzdrav of Russia

119991, Moscow, Russia

A. Ovechkin

The I.M. Sechenov first Moscow medical university of Minzdrav of Russia

119991, Moscow, Russia

参考

  1. Krenk L., Rasmussen L.S. Postoperative delirium and postoperative cognitive dysfunction in the elderly-what are the differences? Minerva Anestesiol. 2011; 77 (7): 742-9.
  2. Monk T.G. et al. Predictors of cognitive dysfunction after major noncardiac surgery. Anesthesiology. 2008; 108 (1): 18-30.
  3. Steinmetz J. et al. Long-term consequences of postoperative cognitive dysfunction. Anesthesiology. 2009; 110 (3): 548-55.
  4. Шнайдер Н.А., Шпрах В.В., Салмина А.Б. Постоперационная когнитивная дисфункция (диагностика, профилактика, лечение). Красноярск: Новые компьютерные технологии; 2005.
  5. Newman S. et al. Postoperative cognitive dysfunction after noncardiac surgery: a systematic review. Anesthesiology. 2007; 106 (3): 572-90.
  6. Rasmussen L.S. Postoperative cognitive dysfunction: incidence and prevention. Best Pract. Res. Clin. Anaesthesiol. 2006; 20 (2): 315-30.
  7. Scott J.E., Mathias J.L., Kneebone A.C. Postoperative Cognitive Dysfunction after Total Joint Arthroplasty in the Elderly: A Meta-Analysis. J. Arthroplasty. 2014; 29 (2): 261-7.
  8. Корячкин В.А. Послеоперационный делирий: факторы риска и профилактика в ортопедотравматологической практике (обзор литературы). Травматология и ортопедия России. 2013; 2 (68): 128.
  9. Захаров В.В., Яхно Н.Н. Когнитивные расстройства в пожилом и старческом возрасте. Методическое пособие для врачей. М.; 2005.
  10. Crosby G., Culley D.J. Anesthesia, the aging brain, and the surgical patient. Can. J. Anesth. 2003; 50: R60-4.
  11. Petersen R.C., Negash S. Mild cognitive impairment: an overview. CNS Spectr. 2008; 13 (1): 45.
  12. Rasmussen L.S. et al. The assessment of postoperative cognitive function. Acta Anaesthesiol. Scand. 2001; 45 (3): 275-89.
  13. Nasreddine Z.S. et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J. Am. Geriatr. Soc. 2005; 53 (4): 695-9.
  14. Costa A.S. et al. Alternate-form reliability of the Montreal Cognitive Assessment screening test in a clinical setting. Dement. Geriatr. Cogn. Disord. 2012; 33 (6): 379-84.
  15. Costa A.S. et al. Evidence of the Sensitivity of the MoCA Alternate Forms in Monitoring Cognitive Change in Early Alzheimer's Disease. Dement. Geriatr. Cogn. Disord. 2013; 37 (1-2): 95-103.
  16. Folstein M.F., Folstein S.E., McHugh P.R. "Mini-mental state": a practical method for grading the cognitive state of patients for the clinician. J. Psychiatr. Res. 1975; 12 (3): 189-98.
  17. Brand N., Jolles J. Learning and retrieval rate of words presented auditorily and visually. J. Gen. Psychol. 1985; 112 (2): 201-10.
  18. Reitan R.M. Validity of the Trail Making Test as an indicator of organic brain damage. Percept. Mot. Skills. 1958; 8 (3): 271-6.
  19. Houx P.J., Jolles J., Vreeling F.W. Stroop interference: aging effects assessed with the Stroop Color-Word Test. Exp. Aging Res. 1993; 19 (3): 209-24.
  20. Lezak MD. Neuropsychological assessment. New York: Oxford University Press; 1995.
  21. Dubois B. et al. The FAB A frontal assessment battery at bedside. Neurology. 2000; 55 (11): 1621-6.
  22. Hovens I.B. et al. Thinking through postoperative cognitive dysfunction: how to bridge the gap between clinical and pre-clinical perspectives. Brain Behav. Immun. 2012; 26 (7): 1169-79.

版权所有 © Eco-Vector, 2015


 


##common.cookie##