ANALYSIS OF THE OCCURRENCE OF POSTOPERATIVE COGNITIVE DYSFUNCTION IN OBESE PATIENTS AFTER HIP ARTHROPLASTY UNDER SPINAL ANESTHESIA

Abstract

The article analyzes the dynamics of cognitive dysfunction and the dependence of the occurrence of postoperative cognitive dysfunction (POCD) in obese patients after hip arthroplasty under spinal anesthesia. The Mini Mental State Examination (MMSE) scale was used as one of the main evaluation scales of POCD. On the day of admission, the patient’s BMI was calculated. Neuropsychological testing was performed in dynamics: 1) the day before surgery; 2) 3 days after the operation – as of the 4th day; 3) after 6 days – as of the 7th day and 4) the day before discharge from the hospital. The number of patients included in the study is 120 patients. Depending on the level of the average MMSE score in the postoperative period in relation to the level in the admission period, retrospectively divided into groups: «Without negative dynamics of cognitive functions» (n=85) and «With negative dynamics of cognitive functions» (n=35). The analysis of the average value of the body mass index and the character of the physique of patients depending on the dynamics of cognitive function the day before discharge indicated only the presence of a tendency to increase the average value of the body mass index (27.6 vs. 25.8 kg/m2, p=0.14 for T -test for Independent Samples) and cases with severe alimentary- constitutional obesity (7.7 % vs. 0.9 %, p=0.07 according to the χ2 test) in the group of patients with negative dynamics of cognitive function compared to the group without it. Thus, the results of the analysis suggest a certain dependence of severe obesity with the development of cognitive disorders.