Abstract:
Elderly patients undergoing surgery are at higher risk of life-altering and costly complications. This challenge is increasingly recognized with the growing geriatric surgical population. Advanced age and comorbid conditions, such as disability and frailty that often develop with age, are all independent risk factors of postoperative morbidity and mortality. A common factor in this age group is cognitive impairment, which poses a challenge for the patient and clinician in the perioperative setting. It affects the capacity for informed consent and limits optimization before surgery; furthermore, an existing impairment may progress in severity during the perioperative period, and new onset of signs of delirium or postoperative cognitive dysfunction may arise during postoperative recovery. In this article, we aim to review the current literature examining the latest definitions, diagnostic criteria, and preventive strategies that may ameliorate postoperative cognitive complications.
摘要:
接受手术的老年患者发生改变生活和昂贵并发症的风险更高。随着老年外科人口的增长,这一挑战越来越被人们认识到。高龄和合并症,例如经常随着年龄增长的残疾和虚弱,都是术后发病率和死亡率的独立危险因素。这个年龄段的一个共同因素是认知障碍,这对围手术期患者和临床医生构成了挑战。它会影响知情同意的能力,并限制手术前的优化;此外,在围手术期,现有的损伤可能在严重程度上进展,术后恢复期间可能出现新的谵妄或术后认知功能障碍。在这篇文章中,我们的目标是回顾当前研究最新定义的文献,诊断标准,以及可以改善术后认知并发症的预防策略。