Evidence map›Paper›PMID 37950163›Full record

Observational studyBMC anesthesiology2023

Association between anaesthesia-related factors and postoperative neurocognitive disorder: a post-hoc analysis.

Manon Stern, Gertrude J Nieuwenhuijs-Moeke, Anthony Absalom, Barbara van Leeuwen, Hanneke van der Wal-Huisman, Matthijs Plas, Dirk J Bosch

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC anesthesiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
2.4field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Manon SternDepartment of Anesthesiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Gertrude J Nieuwenhuijs-MoekeDepartment of Anesthesiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Anthony AbsalomDepartment of Anesthesiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Barbara van LeeuwenDepartment of Surgery/ Surgical Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Hanneke van der Wal-HuismanDepartment of Surgery/ Surgical Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Matthijs PlasDepartment of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Dirk J BoschDepartment of Anesthesiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. d.j.bosch@umcg.nl.
University Medical Center Groningen · NLUniversity of Groningen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPostoperative neurocognitive disorder (pNCD) is common after surgery. Exposure to anaesthetic drugs has been implicated as a potential cause of pNCD. Although several studies have investigated risk factors for the development of cognitive impairment in the early postoperative phase, risk factors for pNCD at 3 months have been less well studied. The aim of this study was to identify potential anaesthesia-related risk factors for pNCD at 3 months after surgery.

methodsWe analysed data obtained for a prospective observational study in patients aged ≥ 65 years who underwent surgery for excision of a solid tumour. Cognitive function was assessed preoperatively and at 3 months postoperatively using 5 neuropsychological tests. Postoperative NCD was defined as a postoperative decline of ≥ 25% relative to baseline in ≥ 2 tests. The association between anaesthesia-related factors (type of anaesthesia, duration of anaesthesia, agents used for induction and maintenance of anaesthesia and analgesia, the use of additional vasoactive medication, depth of anaesthesia [bispectral index] and mean arterial pressure) and pNCD was analysed using logistic regression analyses. Furthermore, the relation between anaesthesia-related factors and change in cognitive test scores expressed as a continuous variable was analysed using a z-score.

resultsOf the 196 included patients, 23 (12%) fulfilled the criteria for pNCD at 3 months postoperatively. A low preoperative score on Mini-Mental State Examination (OR, 8.9 [95% CI, (2.8-27.9)], p < 0.001) and a longer duration of anaesthesia (OR, 1.003 [95% CI, (1.001-1.005)], p = 0.013) were identified as risk factors for pNCD. On average, patients scored higher on postoperative tests (mean z-score 2.35[± 3.13]).

conclusionIn this cohort, duration of anaesthesia, which is probably an expression of the complexity of the surgery, was the only anaesthesia-related predictor of pNCD. On average, patients' scores on cognitive tests improved postoperatively.

Indexed as

AnesthesiaCognitive DysfunctionHumansNeurocognitive DisordersNeuropsychological TestsPostoperative ComplicationsAnaesthesiaPostoperative cognitive dysfunction (POCD)Postoperative complicationsPostoperative neurocognitive disorder (pNCD)

Identifiers

PMID37950163
PMCPMC10636964
OpenAlexW4388572107

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.