Perioperative neurocognitive disorder – advanced narrative review

Czech version

Authors: K. Nekvindová ^1,2; Kateřina Ivanová ²; L. Juríčková ²; D. Tučková ²; J. Vévoda ²; T. Gabrhelík ¹
Authors‘ workplace: ARIM Krajská nemocnice Tomáše Bati, a. s., Zlín ¹; Lékařská fakulta Univerzity Palackého v Olomouci, Ústav veřejného zdravotnictví ²
Published in: Anest. intenziv. Med., 33, 2022, č. 1, s. 39-44
Category: Review Article

Overview

Term postoperative cognitive disorder stands for deterioration of cognitive function after surgery in postoperative period. Evaluation and diagnostics of cognitive disorders in perioperative period were highlighted by the increasing number of geriatric patients undergoing a surgery with general anaesthesia, with the goal of fast recovery and preservation of the quality of life. Deterioration in cognitive function after surgery was originally called postoperative cognitive dysfunction. The definitions of postoperative cognitive dysfunction varied. In order to unite them, in 2018 there were published new recommendations during which the postoperative cognitive dysfunction was replaced by the term perioperative neurocognitive disorder. This was divided based on different time frames of onset to pre-existing neurocognitive disorder, postoperative delirium, delayed neurocognitive disorder and (postoperative) neurocognitive disorder. Main goals of this advanced narrative review were description of terminology, identification of risk factors, prevention, and therapy of perioperative neurocognitive disorder.

Keywords:

postoperative cognitive dysfunction – perioperative neurocognitive disorder – postoperative delirium – general anaesthesia

Sources

1. Mahanna‑ Gabrielli E, Eriksson L, Browndyke J, Wright C, Evered L, Scott A, et al. State of the clinical science of perioperative brain health: report from the American Society of Anesthesiologists Brain Health Initiative Summit 2018. BJA [online]. 2019 [cit. 2021-07-4];123(4):464-470. Dostupné z: https://www.bjanaesthesia.org/article/S0007-0912(19)30556-2/fulltext.

2. O’ Brien H, Mohan H, Hare CO, Reynolds JV, Kenny RA. Mind over matter? the hidden epidemic of cognitive dysfunction in the older surgical patient. Ann Surg [online]. 2017 [cit. 2021-5-7];265(4):677-691. Dostupné z: https://pubmed.ncbi.nlm.nih.gov/27537541/ doi: 10.1097/SLA.0000000000001900.

3. Eckenhoff RG, Maze M, Xie Z, Culley DJ, Goodlin SJ, Zuo Z, Wei H, Whittington RA, Terrando N, Orser BA, Eckenhoff MF. Perioperative Neurocognitive Disorder: State of the Preclinical Science. Anesthesiology. 2020 Jan;132(1):55-68. doi: 10.1097/ALN.0000000000002956. PMID: 31834869; PMCID: PMC6913778.

4. Boone MD, Sites B, Recklinghausen FM, Mueller A, Taenzer AH, Shaefi S. Economic burden of postoperative neurocognitive disorders among US medicare patients. JAMA Netw Open [online]. 2020 [cit. 2021–07-01]. 3(7): e208931. doi:10.1001/jamanetworkopen.2020.8931.

5. Evered L, Silbert B, Knopman D, Scott D, DeKosky S, Rasmussen L, et al. Recommendation for the nomenclature of cognitive change associated with anaesthesia and surgery-2018. BJA [online]. 2018 [cit. 2021-4-7];121(5): 1005-1012. Dostupné z: https://www.bjanaesthesia.org/article/S0007-0912(17)54082-9/fulltext#relatedArticles.

6. Evered L, Scott DA, Silbert B, Maruff P. Postoperative cognitive dysfunction is independent of type of surgery and anesthetic. Anesth Analg. [online]. 2011 [cit. 2021-06-28];112(5):1179-1185. Dostupné z: https://pubmed.ncbi.nlm.nih.gov/21474666/. doi: 10.1213/ANE.0b013e318215217e.

7. Tzimas P, Andritsos E, Arnaoutoglou E, Papathanakos G, Papadopoulos G. Short‑term postoperative cognitive function of elderly patients undergoing first versus repeated exposure to general anaesthesia. Middle East J Anaesthesiol. [online]. 2016 [cit. 2021-07-11]; 23(5):535-542. Dostupné z: https://pubmed.ncbi.nlm.nih.gov/27487639/.

8. Culley DJ, Flaherty D, Fahey MC, Rudolph JL, Javedan H, Huang CC, et al. Poor performance on a preoperative cognitive screening test predicts postoperative complications in Older Orthopedic Surgical Patients. Anesthesiology [online]. 2017 [cit. 2021-07-16]; Nov;127(5):765-774. doi: 10.1097/ALN.0000000000001859.

9. Aldecoa C, Bettelli G, Bilotta F, Sanders RD, Audisio R, Borozdina A, et al. European society of anaesthesiology evidence‑based and consensus‑based guideline on postoperative delirium. Eur J Anaesthesiol. [online]. 2017 [cit. 2021-07-28]; 2017 Apr;34(4):192-214. doi: 10.1097/EJA.0000000000000594.

10. American Geriatrics Society Expert Panel on Postoperative Delirium in Older Adults. American geriatrics society abstracted clinical practice guideline for postoperative delirium in older adults. J Am Geriatr Soc. [online]. 2015 [cit. 2021-07-26]; 63(1):142-150. doi: 10.1111/jgs.13281.

11. Berian JR, Zhou L, Russell MM, Hornor MA, Cohen ME, Finlayson E, Ko CY, Rosenthal RA, Robinson TN. Postoperative Delirium as a target for surgical quality improvement [online]. 2018 [cit. 2021-06-17];268(1):93-99. doi: 10.1097/SLA.0000000000002436.

12. Berger M, Schenning KJ, Brown CH, Deiner SG, Whittington RA, Eckenhoff RG, Angs MS, et al. Perioperative Neurotoxicity Working Group. Best practices for postoperative brain health: Recommendations from the fifth international perioperative neurotoxicity working group. Anesthesia and Analgesia [online]. 2018 [cit. 2021-07-3];127(6):1406-1413. doi: 10.1213/ane.0000000000003841.

13. Scott DA, Evered L, Maruff P, MacIsaac A, Maher S, Silbert BS. Cognitive function before and after left heart catheterization. J Am Heart Assoc. [online]. 2018 [cit. 2021-07-6];10;7(6): e008004. doi: 10.1161/JAHA.117.008004.

14. Watt J, Tricco AC, Talbot‑Hamon C, Pham B, Rios P, Grudniewicz A, et al. Identifying older adults at risk of delirium following elective surgery: a systematic review and meta‑analysis. Journal of general internal medicine [online]. 2018 [cit. 2021-07-3]; 33(4),500-509. Dostupné z: https://doi.org/10.1007/s11606-017-4204-x.

15. Dasgupta M, Dumbrell AC. Preoperative risk assessment for delirium after noncardiac surgery: a systematic review. Journal of the American Geriatrics Society [online]. 2006 [cit. 2021–07-10]; 54(10),1578-1589. Dostupné z: https://doi.org/10.1111/j.1532-5415.2006.00893.x.

16. Scholz AF, Oldroyd C, McCarthy K, Quinn TJ, Hewitt J. Systematic review and meta‑analysis of risk factors for postoperative delirium among older patients undergoing gastrointestinal surgery. The British journal of surgery [online]. 2016 [cit. 2021-07-6];103(2), e21-e28. Dostupné z: https://doi.org/10.1002/bjs.10062.

17. Todd OM, Gelrich L, MacLullich AM, Driessen M, Thomas C, Kreisel SH. Sleep disruption at home as an independent risk factor for postoperative delirium. Journal of the American Geriatrics Society [online]. 2017 [cit. 2021-07-9];65(5),949-957. Dostupné z: https://doi.org/10.1111/jgs.14685.

18. Feinkohl I, Winterer G, Pischon T. Diabetes is associated with risk of postoperative cognitive dysfunction: a meta‑analysis. Diabetes Metab Res Rev. [online]. 2017 [cit. 2021-07-26]; 33(5):10. doi:10.1002/dmrr.2884.

19. Hermanides J, Qeva E, Preckel B, Bilotta F. Perioperative hyperglycemia and neurocognitive outcome after surgery: a systematic review. Minerva Anestesiol. [online]. 2018 [cit. 2021-07-13];84(10):1178-1188. doi: 10.23736/S0375-9393. 18. 12400-X.

20. Borozdina A, Qeva E, Cinicola M, Bilotta F. Perioperative cognitive evaluation. Curr Opin Anaesthesiol. [online]. 2018 [cit. 2021-07-20];31(6):756-776. doi: 10.1097/ACO.0000000000000658.

21. Kant IMJ, de Bresser J, van Montfort SJT, Slooter AJC, Hendrikse J. Markers of neurodegenerative and neurovascular changes in relation to postoperative delirium and postoperative cognitive decline. Am J Geriatr Psychiatry [online]. 2017 [cit. 2021-07-18];25(10): 1048-1061. doi: 10.1016/j.jagp.2017. 06. 016.

22. Brown CH 4th, Max L, LaFlam A, Kirk L, Gross A, Arora R, et al. The association between preoperative frailty and postoperative delirium after cardiac surgery. Anesth Analg. [online]. 2016 [cit. 2021-07-24];123(2):430-435. doi: 10.1213/ANE.0000000000001271.

23. Nomura Y, Faegle R, Hori D, Al‑Qamari A, Nemeth AJ, Gottesman R, et al. Cerebral small vessel, but not large vessel disease, is associated with impaired cerebral autoregulation during cardiopulmonary bypass: a retrospective cohort study. Anesth Analg. [online]. 2018 [cit. 2021-07-15];127(6):1314-1322. doi: 10.1213/ANE.0000000000003384.

24. Lin HS, McBride RL, Hubbard RE, McBride RL, Hubbard RE. Frailty and anesthesia - risks during and post‑surgery. Local Reg Anesth. [online]. 2018 [cit. 2021-07-14];11:61-73. doi: 10.2147/LRA.S142996.

25. Knaak C, Brockhaus WR, Spies C, Borchers F, Piper K, Radtke FM, et al. Presurgical cognitive impairment is associated with postoperative delirium and postoperative cognitive dysfunction. Minerva anestesiologica [online]. 2020 [cit. 2021-07-10];86(4),394-403. Dostupné z: https://doi.org/10.23736/S0375-9393. 20. 13903-8.

26. Beishuizen SJ, Scholtens RM, van Munster BC, de Rooij SE. Unraveling the relationship between delirium, brain damage, and subsequent cognitive decline in a cohort of individuals undergoing surgery for hip fracture. J Am Geriatr Soc. [online]. 2017 [cit. 2021-07-27];65(1):130-136. doi: 10.1111/jgs.14470.

27. Schulte PJ, Roberts RO, Knopman DS, Petersen RC, Hanson AC, Schroeder DR, et al. Association between exposure to anaesthesia and surgery and long‑term cognitive trajectories in older adults: report from the Mayo Clinic Study of Aging. Br J Anaesth. [online]. 2018 [cit. 2021-07-22];121(2):398-405. doi: 10.1016/j.bja.2018. 05. 060.

28. Berian JR, Zhou L, Russell MM, Hornor MA, Cohen ME, Finlayson E, et al. Postoperative delirium as a target for surgical quality improvement. Ann Surg. [online]. 2018 [cit. 2021-07-11]; 268(1):93-99. doi: 10.1097/SLA.0000000000002436.

29. Berger M, Terrando N, Smith SK, Browndyke JN, Newman MF, Mathew JP. Neurocognitive function after cardiac surgery: from phenotypes to mechanisms. Anesthesiology [online]. 2018 [cit. 2021-08-12]; 129(4):829-851. doi: 10.1097/ALN.0000000000002194.

30. Pandharipande PP, Girard TD, Jackson JC, Morandi A, Thompson JL, Pun BT, et al. Long‑term cognitive impairment after critical illness. The New England journal of medicine [online]. 2013 [cit. 2021-07-22];369,14:1306-1316. doi:10.1056/NEJMoa1301372.

31. Zhu S, Zhao S, Wang X. Effect of intraoperative sedation on PND in elderly patients effect of intraoperative sedation on perioperative neurocognitive disorders in elderly patients., EBM Reviews – Cochrane Central Register of Controlled Trials [online]. 2021 [cit. 2021-07-14]. NCT04891458. Dostupné z: https://clinicaltrials.gov/show/NCT04891458.

32. Ji MH, Qiu LL, Mao MJ, Zhang L, Yang JJ. Hippocampal complement C3 might contribute to cognitive impairment induced by anaesthesia and surgery. Neuroreport [online]. 2020 [cit. 2021-07-23]; 7;31(7):507-514. doi: 10.1097/WNR.0000000000001422.

33. Petersen RC, Roberts RO, Knopman DS, Boeve BF, Geda YE, Ivnik RJ, et al. Mild cognitive impairment: ten years later. Arch Neurol. [online]. 2009 [cit. 2021-06-27]; Dec;66(12):1447-55. doi: 10.1001/archneurol.2009.266.

34. Janjua MS, Spurling BC, Arthur ME. Postoperative Delirium. In: StatPearls Treasure Island (FL): StatPearls Publishing [online]. 2021 [cit. 2021-07-11]. Dostupné z: https://www.ncbi.nlm.nih.gov/books/NBK534831/.

35. Devlin JW, Fong JJ, Fraser GL, Riker RR. Delirium assessment in the critically ill. Intensive Care Med. [online]. 2007 [cit. 2021-07-14]; 33(6):929-940. doi: 10.1007/s00134-007-0603-5

36. Hewer CL. The stages and signs of general anaesthesia. Br Med J. [online]. 1937 [cit. 2021-07-18]; 7;2(3996):274-6. doi: 10.1136/bmj.2.3996.274.

37. Card E, Pandharipande P, Tomes C, Lee C, Wood J, Nelson D, et al. Emergence from general anaesthesia and evolution of delirium signs in the post‑anaesthesia care unit. Br J Anaesth. [online]. 2015 [cit. 2021-07-14]; 115(3):411-417. doi: 10.1093/bja/aeu442.

38. Guenther U, Riedel L, Radtke FM. Patients prone for postoperative delirium: preoperative assessment, perioperative prophylaxis, postoperative treatment. Curr Opin Anaesthesiol. [online]. 2016 [cit. 2021-06-22]; 29(3):384-390. doi: 10.1097/ACO.0000000000000327.

39. Munk L, Andersen G, Møller AM. Post‑anaesthetic emergence delirium in adults: incidence, predictors and consequences. Acta Anaesthesiol Scand. [online]. 2016 [cit. 2021-07-20]; 60(8):1059-1066. doi: 10.1111/aas.12717.

40. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. Fifth Edition, Washington DC: American Psychiatric Association Publishing [online]. 2013 [cit. 2021-07-14];598-602. Dostupné z: http://repository.poltekkes‑kaltim.ac.id/657/1/Diagnostic%20and%20statistical%20manual%20of%20mental%20disorders%20_%20DSM-5%20%28%20PDFDrive.com%20%29.pdf.

41. Robinson TN, Raeburn CD, Tran ZV, Angles EM, Brenner LA, Moss M. Postoperative delirium in the elderly: risk factors and outcomes. Ann Surg. [online]. 2009 [cit. 2021-07-11]; 249(1):173-8. doi: 10.1097/SLA.0b013e31818e4776.

42. Zugni N, Guadrini L, Rasulo F. Non‑invasive neuromonitoring in the operating room and its role in the prevention of delirium. Best Pract Res Clin Anaesthesiol. [online]. 2020 [cit. 2021-07-11]; 35(2):191-206. doi: 10.1016/j.bpa.2020. 09. 006.

43. Kenndy M, Enander RA, Tadiri SP, Wolfe RE, Shapiro Ni, Marcatonio ER. Delirium risk prediction, healthcare use and mortality of eldery adulst in the emergency department. J Am Geriatr. [online]. 2014 [cit. 2021-07-19]; 62(3):462-9. doi: 10.1111/jgs.12692.

44. Macedo G, Diógenes A, Remígio D, Correia M, Pinheiro F, Rêgo A, et al. Delirium in the elderly hospitalized. Literature Review [online]. 2019 [cit. 2021-07-11]. 10. 30-36. Dostupné z: https://www.researchgate.net/publication/330184078_Delirium_In_The_Elderly_Hospitalized_A_Literature_Review.

45. Vincent JL, Shehabi Y, Walsh TS, Pandharipande PP et al. Comfort and patient‑centred care without excessive sedation: the eCASH concept. Intensive Care Med. [online]. 2016 [cit. 2021-07-12]. Jun;42(6):962-71. doi: 10.1007/s00134-016-4297-4.

46. Belrose JC, Noppens RR. Anesthesiology and cognitive impairment: a narrative review of current clinical literature. BMC Anesthesiol. [online]. 2019 [cit. 2021-08-12]. 27;19(1):241. doi: 10.1186/s12871-019-0903-7.

47. Newman S, Klinger L, Venn G, Smith P, Harrison M, Treasure T. Subjective reports of cognition in relation to assessed cognitive performance following coronary artery bypass surgery. J Psychosom Res. [online]. 1989 [cit. 2021-07-22]; 33(2):227-33. doi: 10.1016/0022-3999(89)90050-0.

48. Sessums LL, Zembrzuska H, Jackson JL. Does this patient have medical decision‑making capacity? JAMA [online]. 2011 [cit. 2021-07-16]; 27;306(4):420-7. doi: 10.1001/jama.2011.1023.

49. Borchers F, Knaak C, Piper SK, Spies C. Empfehlungen zur erfassung und beschreibung perioperativer kognitiver störungen in wissenschaft und praxis [Recommendations for the detection and specification of perioperative neurocognitive disorders]. Anasthesiol Intensivmed Notfallmed Schmerzther [online]. 2019 [cit. 2021-08-12]; 54(11-12):652-667. German. doi: 10.1055/a-0853-3060.

50. Bartoš A. Nové testy paměti. [online]. 2018. [cit. 13. 10. 2021]. Dostupné z: https://www.nudz.cz/adcentrum/dokumenty/3_Bartos_Nove_Testy_Pameti_Zlist_2018.pdf.

51. Norris CM, Close JCT. Prehabilitation for the frailty syndrome: improving outcomes for our most vulnerable patients. Anesth Analg. [online]. 2020 [cit. 2021-08-10]. 130(6):1524-1533. doi: 10.1213/ANE.0000000000004785.