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Postoperative cognitive dysfunction in geriatric patients

Postoperative kognitive Dysfunktion bei geriatrischen Patienten

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Abstract

Postoperative cognitive dysfunction (POCD) is a severe long-term complication after surgical procedures. POCD is mainly seen among geriatric patients. Hospitalization, extent of surgery, and systemic inflammatory response might contribute to POCD. The possible influence of the type of anesthesia is discussed. POCD is often not recognized; thus, incidence rates are likely to be underestimated (19–40%). POCD is associated with major consequences for the individual patient, e.g., delayed long-term recovery, reduced quality of life, and an increased mortality rate. Multiple risk factors have been identified over the last decade. However, the exact etiology is still unknown. This mini-review summarizes the recent developments concerning POCD prevention, diagnosis, and treatment.

Zusammenfassung

Die postoperative kognitive Dysfunktion (POCD) ist eine schwere, langfristige Komplikation nach chirurgischen Eingriffen. Sie wird vor allem bei geriatrischen Patienten beobachtet. Die Krankenhausaufnahme, der Umfang des chirurgischen Eingriffs und die systemische Entzündungsreaktion hierauf tragen zum klinischen Bild der POCD bei. Ein möglicher Einfluss der Anästhesietechnik wird diskutiert. Die POCD wird oft nicht erkannt, sodass die Inzidenz mit 19–40% wahrscheinlich eine Unterschätzung ist. Sie ist verbunden mit ernsten Folgen für den individuellen Patient, z. B. langfristig verzögerter Genesungsverlauf, verminderte Lebensqualität sowie erhöhte Mortalität. Mehrere Risikofaktoren für das Entstehen der POCD wurden in den vergangenen Jahren identifiziert. Dennoch ist die exakte Ätiologie noch unbekannt. Das vorliegende kleine Review fasst die aktuellen Erkenntnisse und Entwicklungen hinsichtlich Vorbeugung, Diagnose und Therapie der POCD zusammen.

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There corresponding author states that there are no conflicts of interests.

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Authors and Affiliations

  1. Section of Geriatric Medicine, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, 3000, Rotterdam, The Netherlands

    K.A. Hartholt MD, PhD & T.J.M. van der Cammen MD, PhD

  2. Department of Surgery, Reinier de Graaf Hospital, Delft, The Netherlands

    K.A. Hartholt MD, PhD

  3. Department of Anaesthesiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands

    M. Klimek MD, PhD

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  1. K.A. Hartholt MD, PhD
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  2. T.J.M. van der Cammen MD, PhD
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  3. M. Klimek MD, PhD
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Correspondence to M. Klimek MD, PhD.

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Hartholt, K., van der Cammen, T. & Klimek, M. Postoperative cognitive dysfunction in geriatric patients. Z Gerontol Geriat 45, 411–416 (2012). https://doi.org/10.1007/s00391-012-0326-2

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  • DOI: https://doi.org/10.1007/s00391-012-0326-2

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