Effect of preoperative hospitalization period on post-operative
cognitive dysfunction in patients undergoing hip surgery under regional
anesthesia
Abstract
Objective: The main objective of this prospective and observational
study is to investigate the effect of preoperative hospitalization
period on early postoperative cognitive dysfunction (POCD) development
in patients undergoing total hip replacement surgery under regional
anesthesia. Materials and Methods: Between November 2013 to September
2014, 64 patients were enrolled the study. Test scores were obtained on
the initial admission day (MMT1), 24 hours prior to surgery (MMT2) and
24 hours after the surgery (MMT3). Patients were divided into two groups
according to MMT scores as “no cognitive dysfunction” (Group 1) and
“cognitive dysfunction” (Group 2). Differences between groups were
evaluated statistically. Statistical significance level was set as
p<0.05 in a 95% confidential interval. Results: POCD
incidence rate was calculated as 43.8% in all patients. Preoperative
hospitalization duration was significantly higher in patients with POCD
when compared to patients without POCD (p<0,001). The factors
which affect POCD development were found to be advanced age
(p<0,001), high ASA scores (p=0,004), presence of comorbid
disease (p=0,025), duration of operation (p=0,018) and decreased
postoperative hematocrit levels (p=0,014). Conclusion: In this study, we
observed patients with early POCD had a relatively longer pre-operative
hospitalization period when compared to patients without POCD. We
consider that the prolonged preoperative hospitalization periods may
contribute to increased POCD incidence rates in patients with risk
factors.