Title Utjecaj anestezije na kognitivne sposobnosti bolesnika
Author Nadija Gačo
Mentor Vlatka Sotošek Tokmadžić (mentor)
Committee member Alan Šustić (predsjednik povjerenstva)
Committee member Alen Protić (član povjerenstva)
Committee member Igor Antončić (član povjerenstva)
Granter University of Rijeka Faculty of Medicine (Department of Anaesthesiology,reanimatology and Intensive Care) Rijeka
Defense date and country 2017-07-14, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Anesthesiology and Reanimatology
Abstract Cilj: Cilj ovog istraživanja bio jest utvrditi učestalost i karakteristike poslijeoperacijskog poremećaja kognitivnih funkcija (POCD, engl. postoperative cognitive dysfunction) u bolesnika starijih od 18 godina kojima je bio učinjen nekardiokiruški zahvat. Dodatni cilj istraživanja bio je ispitati kognitivne sposobnosti bolesnika prije operacije, 7 dana poslije operacije i 3 mjeseca nakon operacije te utvrditi utječu li dob i komorbiditeti na učestalost POCD-a.
Ispitanici i metode: Prospektivnim istraživanjem obuhvaćeno je 63 ispitanika liječenih u Kliničkom bolničkom centru Rijeka. Svaki ispitanik je prije operacije, 7 dana te tri mjeseca nakon operacije ispunio MoCA test. Iz istraživanja su isključeni pacijenti mlađi od 18 godina i stariji od 75 godina te pacijenti koji imaju mentalnu retardaciju i demenciju.
Rezultati: Znakovi POCD-a sedam dana nakon operacije bili su prisutni u 25 (40%) bolesnika, a tri mjeseca nakon operacije u 8 (13%) bolesnika. Statistički značajna razlika (p<0,0001) pronađena je između ostvarenog broja bodova na MoCA testu testa prije operacije i 7 dana nakon operacije, kao i 7 dana nakon operacije i 3 mjeseca nakon operacije, dok nije bilo razlike prije operacije i 3 mjeseca nakon (p=0,1673). Analizom pojedinih kategorija MoCA testa statistički značajna razlika pronađena je u kategoriji izvršnih funkcija (p= 0,0008), pažnje (p= 0,019), jezika i govora (p<0,0001) te odgođenog prisjećanja (p=0,017). Dob i komorbiditeti ispitanika nisu imali statistički značajan utjecaj na učestalost POCD-a.
Zaključak: Operacija je dovela do razvoja POCD-a kod značajnog broja ispitanika, no kod većine je ispitanika došlo do regresije unutar 3 mjeseca
Abstract (english) Aim: Primary goal of this study was to establish the frequency and characteristics of postoperative cognitive dysfunction (POCD) in patients undergoing noncardiac surgery. Additional goal was to determine if age and comorbidities have an influence on the incidence of POCD before an operation, 7 days after an operation and 3 months after an operation.
Materials and methods: 63 patients treated in Clinical Hospital Centre Rijeka have completed this prospective study. Montreal Cognitive Assessment Test (MoCA) was used to determine cognitive function before surgery, 7 days and 3 months after surgery. Patients younger than 18 and older than 75 were excluded from the study, as were those suffering from intellectual disability and dementia.
Results: 25 (40%) patients had signs of cognitive dysfunction 7 days after surgery, which persisted in 8 patients (13%) 3 months after surgery. There was significant difference (p<0,0001) in the patients’ MoCA scores before surgery and 7 days after surgery. Significant difference (p<0,0001) was also found in patients’ MoCA scores 7 days and 3 months after surgery, while there was no difference (p=0,06) between the scores before surgery and 3 months after surgery nakon (p=0,1673). There was no statistically significant difference after splitting the patients into groups based on age and comorbidities. When analysing the MoCA test by subcategories, statistically significant difference between the mentioned time periods can be found in the following subcategories: executive functioning (p= 0,0008), attention (p=0,019), language and fluency (p<0,0001) and delayed remembering (p=0,017).
Conclusion: Surgery led to the development of POCD in a significant number of patients, though most recovered in 3 months. POCD is a disease that deserves further study as it can have a significant impact on the quality of life and functioning in the postoperative period
Keywords
anestezija
MoCA test
operacija
POCD
poslijeoperacijski poremećaj kognitivnih funkcija
Keywords (english)
anaesthesia
MoCA test
Montreal Cognitive Assessment Test
operation
postoperative cognitive dysfunction
Language croatian
URN:NBN urn:nbn:hr:184:965994
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
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Created on 2018-06-15 15:18:52