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Peri-Operative Risk Factors Associated with Post-Operative Cognitive Dysfunction (POCD): An Umbrella Review of Meta-Analyses of Observational Studies
journal contribution
posted on 2023-05-03, 22:56 authored by Nikolaj Travica, Mojtaba Lotfaliany Abrand AbadiMojtaba Lotfaliany Abrand Abadi, A Marriott, SA Safavynia, MM Lane, Laura GrayLaura Gray, N Veronese, M Berk, David SkvarcDavid Skvarc, H Aslam, E Gamage, M Formica, K Bishop, Wolf MarxWolf MarxThis 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.
History
Journal
Journal of Clinical MedicineVolume
12Article number
ARTN 1610Location
SwitzerlandPublisher DOI
ISSN
2077-0383eISSN
2077-0383Language
EnglishIssue
4Publisher
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Keywords
Science & TechnologyLife Sciences & BiomedicineMedicine, General & InternalGeneral & Internal Medicinesurgerypsychiatrycognitionrisk factorscognitive dysfunctionpost-operativemeta-reviewneuroscienceperi-operative neurocognitive disorderSURGERYNEUROINFLAMMATIONPREVALENCEANESTHESIADEMENTIADECLINEPreventionCardiovascularClinical Sciences not elsewhere classified