The Occurrence of Postoperative Cognitive Dysfunction (POCD) - Systematic Review

Abstract

Aim: The aim of this systematic review was to summarize the present literature on cognitive dysfunctions in adults after surgical procedures.

Methods: MEDLINE: PubMed, OVID, Web of Science, EBSCO databases have been searched using relevant key words. The literature on cognitive dysfunctions after surgical procedures has been reviewed and the risk factors of POCD occurrence have been analyzed.

Results: The results from seven articles describing neuropsychological studies of 2,796 patients have been analyzed. The tests were conducted within a very short time after the procedure (7 days), within a short time (3 months) and within a long-term perspective (12-60 months). POCD within a very short time after the operation occurred with a different frequency: from 17 to 56% with a tendency to resolve over time (3-34.2%). POCD risk factors have been identified: advanced age, insulin resistance, a short education period. The type of surgical procedure, anesthesia or microembolization related to CPB, does not influence the occurrence of POCD.

Conclusions: It seems that one should focus on searching risk factors outside the procedures, and that certain recommendations should be developed regarding perioperative proceedings which might be beneficial for patients at risk of the impairment of their cognitive functions after a surgical procedure.

Keywords: anesthesia; cognitive functioning; surgical procedure.