Analysis of characteristics of cognitive function of elderly patients after total knee arthroplasty
10.3760/cma.j.issn.1674-6554.2017.02.008
- VernacularTitle:膝关节置换术后老年患者认知状况分析
- Author:
Qian XU
;
Zhichao HE
;
Xia ZHANG
- Keywords:
Elderly;
Knee arthroplasty;
Postoperative cognitive dysfunction;
Risk factors
- From:
Chinese Journal of Behavioral Medicine and Brain Science
2017;26(2):133-138
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the influencing factors of postoperative cognitive dysfunction ( POCD) in elderly patients after knee joint replacement. Methods 165 cases of elderly patients undergo-ing knee replacement surgery were recruited in the study. According to whether there was POCD,the patients were divided into POCD group (35 cases) and non POCD group (130 cases).The gender,age,educational level,medical history,physical exercise,operation mode( cruciate-retaining total knee arthroplasty and poste-rior stabilized total knee arthroplasty) ,operation time,blood loss,preoperative depression score and postoper-ative pain score were recorded and compared.The logistic multiveariate regression analysis was conducted to analyze the risk factors of POCD in elderly patients with knee replacement. Results (1)There were statis-tically significant differences in the total score of MoCA, visual space and executive function,naming and de-laying recall between non-POCD group and POCD group after the operation ( Z=-5. 327, P=0. 000;Z=-3.140, P=0.002;Z=-2.910, P=0.004;Z=-3.333, P=0.001). (2)The results of logistic multiveariate regression analysis showed the age>70 years old ( OR=3.708,95%CI =1.037-13.261, P<0.05) ,hyperten-sion ( OR=5.250,95%CI =1.787-15.423, P<0.05),diabetes ( OR=6.560,95%CI =1.418-30.345, P<0.05) ,preoperative depression ( OR=4.648,95%CI =1.290-16.744, P<0.05) and postoperative pain score>4 ( OR=3.149,95%CI=1.072~9.251, P<0.05) were risk factors of POCD,and physical exercise ( OR=4.330,95%CI =1.294-14.488, P<0.05) and CR-TKA( OR=0.187,95%CI =0.045-0.781, P<0.05) were the protective factors of POCD. Conclusion The overall level of cognitive function in elderly patients after knee replacement surgery is low. The advanced age,hypertension,diabetes,lack of physical exercise,choice of operation method,postoperative pain and preoperative depression are important influence factors of POCD.
