In the ANESTHESIOLOGY® 2017 annual meeting, researchers present findings on postoperative cognitive dysfunction (POCD). It was reported that older patients with diabetes were at to 84% higher risk of developing POCD compared to non-diabetic individuals.
"With POCD, a patient's mental ability declines after surgery, compared to their cognitive performance prior but also impairing the patient's quality of life, "said Gunnar Lachmann,
Postoperative cognitive dysfunction (POCD) is a major form of cognitive disturbances that can occur after anesthesia and surgery. However, the potential risk factors associated with POCD are uncertain. Although the association between diabetes and age-related cognitive impairment is known, the role of diabetes and development of POCD remains unclear.
The researchers performed a secondary analysis of three studies to determine if diabetes was a risk factor for POCD. A total of 1,034 patients with a mean age of 66.4 years (481 had cardiac surgery, and 553 had non-cardiac surgery), among which 18.6% had diabetes, were assessed in this study. Logistic regression models were used to analyze the risk of POCD associated with diabetes. A follow-up over a period of 3 or 12 months was undertaken, and risk estimates were pooled.
In the study, the adjusted for factors like age, surgery type, sex, randomization, obesity, and hypertension. They determined that diabetes was associated with 84% higher risk of POCD, especially in elderly patients (age ≥ 65 years).
"The study outcomes suggest that consideration of diabetes status might be helpful for the determination of POCD risk among patients undergoing surgery, "said Dr. Lachmann. "Further studies are required to examine the potential mechanisms of this association. These studies ultimately help in the development of potential strategies for prevention. "
The American Society of Anesthesiologists (ASA) introduced the Brain Health Initiative in 2015. The new patient safety initiative provides physicians, anesthesiologists, and clinicians involved in perioperative care, including patients and their families caring for older patients with tools and resources to optimize cognitive recovery and the perioperative experience for adults (age ≥ 65 years) undergoing surgeries.