Poor preoperative cognition, as assessed by preoperative Mini-Cog screening, is prevalent among older total joint patients and predictive of adverse outcomes, including postoperative delirium, longer hospital stay, and greater likelihood of discharge to a place other than home, this study finds.
Of 211 patients 65 years of age or older without a diagnosis of dementia who were scheduled for total joint replacement, 50 (24%) screened positive for probable cognitive impairment (Mini-Cog ≤ 2).
On age-adjusted, multivariate analysis, patients with a Mini-Cog ≤ 2 were more likely to:
Preoperative cognitive screening may be valuable for risk assessment and risk stratification of older surgical patients, the authors say.
APPROXIMATELY one of every three surgical procedures nationally is performed on a patient 65 yr of age or older. There is intense interest in identifying predictors of adverse outcomes in this age group, given that they have a high complication rate and often do poorly.1–4 Preoperative assessment of major vital organs has been a routine part of preparation for surgery for decades5,6 but brain function is typically not formally evaluated.7Read More >>