August 7, 2015

Preop cognitive impairment linked to postop cognitive dysfunction after total hip

Postoperative cognitive dysfunction has been identified in patients undergoing noncardiac surgery 3 months after surgery. However, it’s unclear whether preexisting cognitive dysfunction contributes to postoperative cognitive decline.

This Australian study investigates the prevalence of preexisting cognitive impairment in elderly total hip patients and its association with postoperative cognitive dysfunction. The study included 300 total hip patients and 51 nonsurgical controls.

Preoperative cognitive impairment was identified in 32% of patients. It was found to be a good predictor of cognitive dysfunction at 3 months and 1 year and cognitive decline at 1 year after surgery.

The researchers concluded that patients with preexisting cognitive impairment have an increased incidence of postoperative cognitive dysfunction and cognitive decline after hip replacement. Identifying early decline in cognitive function is now routine in geriatric care and an accepted way to identify future cognitive decline. The current findings suggest that preoperative cognitive impairment may similarly predict cognitive decline following surgical intervention, the researchers note.

—Silbert B, Evered L, Biostat M, et al. Preexisting cognitive impairment is associated with postoperative cognitive dysfunction after hip joint replacement surgery. Anesthesiology. 2015;122(6):1224-1234.

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