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Early Cognitive Dysfunction in Elderly Patients after Total Knee Arthroplasty: An Analysis of Risk Factors and Cognitive Functional Levels

BACKGROUND: Cognitive dysfunction after total knee arthroplasty (TKA) is very common in elderly patients. Postoperative cognitive dysfunction (POCD), as a form of cognitive dysfunction, may affect patients' short- and long-term recoveries. The identification of meaningful risk factors may help...

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Autores principales: Ren, Shengjie, Yuan, Fang, Yuan, Shu, Zang, Chuanbo, Zhang, Yanan, Lang, Bao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881138/
https://www.ncbi.nlm.nih.gov/pubmed/35224095
http://dx.doi.org/10.1155/2022/5372603
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author Ren, Shengjie
Yuan, Fang
Yuan, Shu
Zang, Chuanbo
Zhang, Yanan
Lang, Bao
author_facet Ren, Shengjie
Yuan, Fang
Yuan, Shu
Zang, Chuanbo
Zhang, Yanan
Lang, Bao
author_sort Ren, Shengjie
collection PubMed
description BACKGROUND: Cognitive dysfunction after total knee arthroplasty (TKA) is very common in elderly patients. Postoperative cognitive dysfunction (POCD), as a form of cognitive dysfunction, may affect patients' short- and long-term recoveries. The identification of meaningful risk factors may help reduce the occurrence of POCD in the future. OBJECTIVE: Our goal was to retrospectively investigate the risk factors for early POCD in elderly patients undergoing TKA and to further analyze the relationship between the intensity of risk factors and the level of cognitive function. METHODS: The related indicators and the Montreal Cognitive Function Assessment Scale (MOCA) scores of 105 elderly patients were collected by searching the electronic case system. According to the postoperative MOCA score, patients were divided into three groups: normal group (group N), mild POCD group (group M), and severe POCD group (group S). SPSS 25.0 software was used for statistical analyses. RESULTS: At baseline, the preoperative MOCA score was significantly different in patients with POCD (P ≤ 0.001), while other baseline indicators were not significantly different. In terms of changes in hemoglobin levels, statistically significant differences were observed between group M, group S, and group N (P = 0.039). Among inflammatory indicators, only postoperative CRP levels showed a statistically significant difference in patients with POCD (P = 0.041). Postoperative pain was also significantly different among the three groups (P = 0.009). The multivariate regression analysis revealed that a low preoperative MOCA score and severe postoperative pain were independent risk factors for mild and severe cognitive impairment, while a high postoperative CRP level was only an independent risk factor for mild cognitive impairment. CONCLUSIONS: Our study found that the level of preoperative cognitive function, postoperative CRP level, and postoperative pain were independent risk factors for POCD. Moreover, the levels of preoperative cognitive function and postoperative pain were more strongly correlated with severe POCD than postoperative CRP levels.
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spelling pubmed-88811382022-02-26 Early Cognitive Dysfunction in Elderly Patients after Total Knee Arthroplasty: An Analysis of Risk Factors and Cognitive Functional Levels Ren, Shengjie Yuan, Fang Yuan, Shu Zang, Chuanbo Zhang, Yanan Lang, Bao Biomed Res Int Research Article BACKGROUND: Cognitive dysfunction after total knee arthroplasty (TKA) is very common in elderly patients. Postoperative cognitive dysfunction (POCD), as a form of cognitive dysfunction, may affect patients' short- and long-term recoveries. The identification of meaningful risk factors may help reduce the occurrence of POCD in the future. OBJECTIVE: Our goal was to retrospectively investigate the risk factors for early POCD in elderly patients undergoing TKA and to further analyze the relationship between the intensity of risk factors and the level of cognitive function. METHODS: The related indicators and the Montreal Cognitive Function Assessment Scale (MOCA) scores of 105 elderly patients were collected by searching the electronic case system. According to the postoperative MOCA score, patients were divided into three groups: normal group (group N), mild POCD group (group M), and severe POCD group (group S). SPSS 25.0 software was used for statistical analyses. RESULTS: At baseline, the preoperative MOCA score was significantly different in patients with POCD (P ≤ 0.001), while other baseline indicators were not significantly different. In terms of changes in hemoglobin levels, statistically significant differences were observed between group M, group S, and group N (P = 0.039). Among inflammatory indicators, only postoperative CRP levels showed a statistically significant difference in patients with POCD (P = 0.041). Postoperative pain was also significantly different among the three groups (P = 0.009). The multivariate regression analysis revealed that a low preoperative MOCA score and severe postoperative pain were independent risk factors for mild and severe cognitive impairment, while a high postoperative CRP level was only an independent risk factor for mild cognitive impairment. CONCLUSIONS: Our study found that the level of preoperative cognitive function, postoperative CRP level, and postoperative pain were independent risk factors for POCD. Moreover, the levels of preoperative cognitive function and postoperative pain were more strongly correlated with severe POCD than postoperative CRP levels. Hindawi 2022-02-18 /pmc/articles/PMC8881138/ /pubmed/35224095 http://dx.doi.org/10.1155/2022/5372603 Text en Copyright © 2022 Shengjie Ren et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Ren, Shengjie
Yuan, Fang
Yuan, Shu
Zang, Chuanbo
Zhang, Yanan
Lang, Bao
Early Cognitive Dysfunction in Elderly Patients after Total Knee Arthroplasty: An Analysis of Risk Factors and Cognitive Functional Levels
title Early Cognitive Dysfunction in Elderly Patients after Total Knee Arthroplasty: An Analysis of Risk Factors and Cognitive Functional Levels
title_full Early Cognitive Dysfunction in Elderly Patients after Total Knee Arthroplasty: An Analysis of Risk Factors and Cognitive Functional Levels
title_fullStr Early Cognitive Dysfunction in Elderly Patients after Total Knee Arthroplasty: An Analysis of Risk Factors and Cognitive Functional Levels
title_full_unstemmed Early Cognitive Dysfunction in Elderly Patients after Total Knee Arthroplasty: An Analysis of Risk Factors and Cognitive Functional Levels
title_short Early Cognitive Dysfunction in Elderly Patients after Total Knee Arthroplasty: An Analysis of Risk Factors and Cognitive Functional Levels
title_sort early cognitive dysfunction in elderly patients after total knee arthroplasty: an analysis of risk factors and cognitive functional levels
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881138/
https://www.ncbi.nlm.nih.gov/pubmed/35224095
http://dx.doi.org/10.1155/2022/5372603
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