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Review
. 2023 Feb 17;12(4):1610.
doi: 10.3390/jcm12041610.

Peri-Operative Risk Factors Associated with Post-Operative Cognitive Dysfunction (POCD): An Umbrella Review of Meta-Analyses of Observational Studies

Nikolaj Travica  1 , Mojtaba Lotfaliany  1 , Andrew Marriott  2 , Seyed A Safavynia  3 , Melissa M Lane  1 , Laura Gray  4 , Nicola Veronese  5 , Michael Berk  1 , David Skvarc  6 , Hajara Aslam  1 , Elizabeth Gamage  1 , Melissa Formica  2 , Katie Bishop  2 , Wolfgang Marx  1
Affiliations
Review

Peri-Operative Risk Factors Associated with Post-Operative Cognitive Dysfunction (POCD): An Umbrella Review of Meta-Analyses of Observational Studies

Nikolaj Travica et al. J Clin Med. .

Abstract

This umbrella review aimed to systematically identify the peri-operative risk factors associated with post-operative cognitive dysfunction (POCD) using meta-analyses of observational studies. To date, no review has synthesised nor assessed the strength of the available evidence examining risk factors for POCD. Database searches from journal inception to December 2022 consisted of systematic reviews with meta-analyses that included observational studies examining pre-, intra- and post-operative risk factors for POCD. A total of 330 papers were initially screened. Eleven meta-analyses were included in this umbrella review, which consisted of 73 risk factors in a total population of 67,622 participants. Most pertained to pre-operative risk factors (74%) that were predominantly examined using prospective designs and in cardiac-related surgeries (71%). Overall, 31 of the 73 factors (42%) were associated with a higher risk of POCD. However, there was no convincing (class I) or highly suggestive (class II) evidence for associations between risk factors and POCD, and suggestive evidence (class III) was limited to two risk factors (pre-operative age and pre-operative diabetes). Given that the overall strength of the evidence is limited, further large-scale studies that examine risk factors across various surgery types are recommended.

Keywords: cognition; cognitive dysfunction; meta-review; neuroscience; peri-operative neurocognitive disorder; post-operative; psychiatry; risk factors; surgery.

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Conflict of interest statement

The authors declare no conflict of interest. NT has received funding from Deakin University for an Executive Dean’s Post-Doctoral Fellowship. MB is supported by a NHMRC Senior Principal Research Fellowship (1156072). DRS is a current investigator with the NHMRC Medical Research Future Fund (APP1200214). MML is supported by a Deakin University Scholarship and has received research funding support from Be Fit Foods. LE is CIA and is partially supported by a NHMRC Boosting Dementia Project Grant (APP1171174). NV has not COI to declare for this work. WM is currently funded by an NHMRC Investigator Grant (#2008971) and a Multiple Sclerosis Research Australia early-career fellowship. WM has previously received funding from the Cancer Council Queensland and university grants/fellowships from La Trobe University, Deakin University, University of Queensland, and Bond University. WM has received industry funding and/or has attended events funded by Cobram Estate Pty. Ltd. and Bega Dairy and Drinks Pty Ltd. WM has received travel funding from the Nutrition Society of Australia. WM has received consultancy funding from Nutrition Research Australia and ParachuteBH. WM has received speakers honoraria from The Cancer Council Queensland and the Princess Alexandra Research Foundation. SAS is supported by a Mentored Research Training Grant (MRTG) from the Foundation for Anesthesia Education and Research (FAER).

Figures

Figure 1
Figure 1
PRISMA flow chart of study selection. Legend: POCD = post-operative cognitive dysfunction.
See this image and copyright information in PMC

References

    1. Tasbihgou S.R., Absalom A.R. Postoperative neurocognitive disorders. Korean J. Anesthesiol. 2021;74:15–22. doi: 10.4097/kja.20294. - DOI - PMC - PubMed
    1. Evered L., Silbert B., Knopman D.S., Scott D.A., DeKosky S.T., Rasmussen L.S., Oh E.S., Crosby G., Berger M., Eckenhoff R. Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery—2018. Anesthesiology. 2018;129:872–879. doi: 10.1097/ALN.0000000000002334. - DOI - PubMed
    1. American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders, Text Revision (DSM-IV-TR®) American Psychiatric Association; Washington, DC, USA: 2010.
    1. Skvarc D.R., Berk M., Byrne L.K., Dean O.M., Dodd S., Lewis M., Marriott A., Moore E.M., Morris G., Page R.S. Post-operative cognitive dysfunction: An exploration of the inflammatory hypothesis and novel therapies. Neurosci. Biobehav. Rev. 2018;84:116–133. doi: 10.1016/j.neubiorev.2017.11.011. - DOI - PubMed
    1. Eckenhoff R.G., Maze M., Xie Z., Culley D.J., Goodlin S.J., Zuo Z., Wei H., Whittington R.A., Terrando N., Orser B.A. Perioperative neurocognitive disorder: State of the preclinical science. Anesthesiology. 2020;132:55–68. doi: 10.1097/ALN.0000000000002956. - DOI - PMC - PubMed

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