Der Anaesthesist

, Volume 59, Issue 2, pp 177–185 | Cite as

Postoperative kognitive Dysfunktion

Inzidenz und Prophylaxe
CME Weiterbildung · Zertifizierte Fortbildung

Zusammenfassung

Die Inzidenz der postoperativen kognitiven Dysfunktion (POCD) wird oft unterschätzt und ist vielen Anästhesisten nicht unmittelbar präsent. Die POCD tritt häufig bei älteren Patienten auf, kann aber auch bei jungen Patienten vorkommen. Ihre Prävalenz nach großen nichtherzchirurgischen Eingriffen 7 Tage postoperativ liegt bei 19–41% in den Altersklassen der über 18-Jährigen. Drei Monate postoperativ ist nur in der Altersgruppe der über 60-Jährigen eine erhöhte POCD-Rate (10%) nachweisbar. Das Auftreten der POCD ist mit einer erhöhten Mortalitätsrate assoziiert. Die Ätiologie ist trotz aller wissenschaftlichen Bemühungen weitgehend ungeklärt. Das Patientenalter stellt einen Risikofaktor dar. Die Studienlage zur Prophylaxe der POCD ist limitiert. Die Aufrechterhaltung der Homöostase des Patienten ist ein wichtiger Eckpunkt der Prophylaxe.

Schlüsselwörter

Nichtherzchirurgische Eingriffe Risikofaktoren Postoperativer Zeitpunkt Mortalitätsrate Homöostase 

Postoperative cognitive dysfunction

Incidence and prophylaxis

Abstract

The incidence of postoperative cognitive dysfunction (POCD) is often underestimated and not intuitively present by many anesthetists. POCD often occurs in the elderly but is also seen in younger patients. The incidence of POCD 1 week after non-cardiac surgery covers a span between 19–41% in patients older than 18 years. An increased POCD rate (10%) 3 months after surgery is only detected in patients older than 60 years. The occurrence of POCD is associated with an increased mortality rate, jet the etiology is mainly unknown despite enormous research efforts. The age of the patient is one of the main risk factors for the development of POCD. Data on how to avoid POCD are limited. However, the maintenance of homoeostasis is an important cornerstone of prophylaxis.

Keywords

Non-cardiac surgery Risk factors Postoperative time Mortality rate Homeostasis 

Notes

Interessenkonflikt

Die Autoren geben an, dass kein Interessenkonflikt besteht.

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Copyright information

© Springer Medizin Verlag 2010

Authors and Affiliations

  • M. Coburn
    • 1
  • A. Fahlenkamp
    • 1
  • N. Zoremba
    • 1
  • G. Schaelte
    • 1
  1. 1.Klinik für AnästhesiologieUniversitätsklinikum Aachen, RWTH AachenAachenDeutschland

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