Incidence and risk factors assessment of early postoperative cognitive decline in elderly patients after spinal surgery
- VernacularTitle:Өндөр настны нурууны хагалгааны дараах эрт үеийн танин мэдэхүйн бууралтын тохиолдол ба эрсдэлт хүчин зүйлсийн үнэлгээ
- Author:
Ya Tuo
1
,
2
;
Altanchimeg S
2
;
Suvd-Erdene N
2
;
Ganbold L
2
Author Information
1. Department of Critical care and Anesthesiology, School of Medicine, MNUMS
2. Department of Anesthesiology, Affiliated Hospital No.2 of Hohhot, IMAR
- Publication Type:Other Types
- Keywords:
Spinal surgery;
Postoperative cognitive decline (POCD);
Elderly patients;
Risk factors;
Inflammatory re sponse.
- From:
Mongolian Journal of Health Sciences
2025;88(4):128-134
- CountryMongolia
- Language:Mongolian
-
Abstract:
Background:As global life expectancy increases, spinal disorders and the need for spinal surgery among elderly individ
uals are becoming more prevalent. Postoperative cognitive decline (POCD) is a common complication in this population,
adversely affecting functional recovery and quality of life. Despite substantial research, effective preventive strategies for
POCD remain limited.
Aim:To determine the incidence of POCD and to identify perioperative risk factors associated with its development in
elderly patients undergoing spinal surgery.
Materials and Methods:A prospective cohort study was conducted at the Second Affiliated Hospital of Inner Mongolia
Medical University. Of 200 elderly patients who underwent spinal surgery between, 122 met the inclusion criteria and
were enrolled. Preoperative clinical assessments, intraoperative surgical and anesthetic parameters, and postoperative
evaluations were systematically collected. Cognitive function was assessed using standardized and validated tools both
before and after surgery. Multivariate logistic regression analyses were performed to identify independent predictors of
POCD.
Results:POCD was observed in a notable proportion of patients postoperatively. Multivariate analysis revealed that
prolonged surgical duration (OR=0.989; p=0.005), intraoperative hypotension (OR=0.964; p=0.009), higher intensity of
postoperative pain (OR=10.073; p=0.015), and elevated postoperative C-reactive protein levels (OR=1.039; p<0.001)
were significantly associated with an increased risk of developing POCD.
Conclusion: In elderly patients undergoing spinal surgery severe postoperative pain, and systemic inflammatory respons
es contribute significantly to the development of POCD. Optimizing perioperative management, including minimizing
surgical time, maintaining stable hemodynamics, and controlling postoperative inflammation and pain, may mitigate the
risk of cognitive decline.
- Full text:2025052211473935838128-134.pdf
