Postoperative cognitive dysfunction in older patients with a history of alcohol abuse. Anesthesiology 2007 Mar;106(3):423-30
Date
02/28/2007Pubmed ID
17325499DOI
10.1097/00000542-200703000-00005Scopus ID
2-s2.0-34247506262 (requires institutional sign-in at Scopus site) 73 CitationsAbstract
BACKGROUND: Postoperative cognitive dysfunction (POCD) affects a significant number of patients and may have serious consequences for quality of life. Although POCD is most frequent after cardiac surgery, the prevalence of POCD after noncardiac surgery in older patients is also significant. The risk factors for POCD after noncardiac surgery include advanced age and preexisting cognitive impairment. Self-reported alcohol abuse is a risk factor for postoperative delirium, but its significance for long-term POCD has not been investigated. The goal of this study was to determine whether neurocognitive function is impaired after noncardiac surgery during general anesthesia in older patients with a history of alcohol abuse.
METHODS: Subjects aged 55 yr and older with self-reported alcohol abuse (n = 28) and age-, sex-, education-matched nonalcoholic controls (n = 28) were tested using a neurocognitive battery before and 2 weeks after elective surgery (n = 28) or a corresponding time interval without surgery (n = 28). Verbal memory, visuospatial memory, and executive functions were assessed. A neurologic examination was performed to exclude subjects with potential cerebrovascular damage.
RESULTS: Significant three-way interactions (analysis of variance) for Visual Immediate Recall, Visual Delayed Recall, Semantic Fluency, Phonemic Fluency, and the Color-Word Stroop Test implied that cognitive performance in the alcoholic group decreased after surgery more than it did in the other three groups.
CONCLUSIONS: The results suggest that a history of alcohol abuse in older patients presents a risk for postoperative cognitive impairment in the domains of visuospatial abilities and executive functions that may have important implications for quality of life and health risks.
Author List
Hudetz JA, Iqbal Z, Gandhi SD, Patterson KM, Hyde TF, Reddy DM, Hudetz AG, Warltier DCAuthor
Sweeta D. Gandhi MD Associate Professor in the Anesthesiology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedAged, 80 and over
Alcoholism
Analysis of Variance
Anesthesia, General
Cognition
Cognition Disorders
Comorbidity
Elective Surgical Procedures
Humans
Male
Memory, Short-Term
Mental Recall
Middle Aged
Neuropsychological Tests
Postoperative Complications
Prevalence
Risk Factors
Space Perception
Surgical Procedures, Operative
Visual Perception