PREVALENCE OF POSTOPERATIVE COGNITIVE DYSFUNCTION IN ELDERLY PATIENTS UNDERGOING ELECTIVE NEUROSURGICAL PROCEDURES: A CROSS-SECTIONAL STUDY
Keywords:
Aged, Anesthesia, Cognition Disorders, Cross-Sectional Studies, Neurosurgery, Postoperative Complications, PrevalenceAbstract
Background: Postoperative cognitive dysfunction (POCD) is increasingly recognized as a significant complication among elderly patients undergoing major surgical interventions. Despite its clinical relevance, limited evidence specifically addresses its prevalence and determinants in elective neurosurgical settings, where both surgical and anesthetic factors may contribute to postoperative cognitive decline.
Objective: To determine the prevalence of postoperative cognitive dysfunction among elderly patients undergoing elective neurosurgical procedures and to identify perioperative factors associated with its occurrence.
Methods: This cross-sectional study was conducted in a tertiary care center in Lahore over four months, enrolling 200 elderly patients undergoing elective neurosurgery. Participants were assessed using validated neuropsychological tools including the Mini-Mental State Examination (MMSE), Trail Making Tests A and B, and Digit Span, administered preoperatively and within the early postoperative period. Data were analyzed using descriptive statistics, chi-square tests, and independent t-tests. Associations between POCD and perioperative factors were explored, with significance set at p<0.05.
Results: Among the 200 participants, 98 (49.0%) were male, 96 (48.0%) female, and 6 (3.0%) other gender, with a mean age of 66.2 ± 4.8 years. POCD was identified in 54 patients (27.0%). Significant postoperative declines were observed across cognitive domains, with mean MMSE scores decreasing from 27.8 ± 1.9 preoperatively to 25.6 ± 2.4 postoperatively. Trail Making Test performance worsened significantly, and Digit Span scores declined. Advanced age, anesthesia duration greater than four hours, and intraoperative blood loss exceeding 500 ml were significantly associated with POCD (p<0.05).
Conclusion: POCD was prevalent in more than one-quarter of elderly neurosurgical patients, with identifiable perioperative risk factors. These findings underscore the importance of perioperative cognitive monitoring and targeted interventions to mitigate decline in this vulnerable population.
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Copyright (c) 2025 Ahmed Ur Rehman, Ayesha Asghar, Jahanzeb Akhtar (Author)
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