Preoperative Cognitive Impairment as a Predictor of Postoperative Outcomes in Elderly Patients Undergoing Spinal Surgery for Degenerative Spinal Disease.

Hyung Cheol Kim,Seong Yi,Phil Hyu Lee,Hyeongseok Jeon,Jae Keun Oh,Seong Bae An,Tae Woo Kim,Keung Nyun Kim,Dong Ah Shin,Suk Yun Kang,Yoon Ha

doi:10.3390/jcm10071385

Abstract

Cognitive status has been reported to affect the peri-operative and post-operative outcomes of certain surgical procedures. This prospective study investigated the effect of preoperative cognitive impairment on the postoperative course of elderly patients (n = 122, >65 years), following spine surgery for degenerative spinal disease. Data on demographic characteristics, medical history, and blood analysis results were collected. Preoperative cognition was assessed using the mini-mental state examination, and patients were divided into three groups: normal cognition, mild cognitive impairment, and moderate-to-severe cognitive impairment. Discharge destinations (p = 0.014) and postoperative cardiopulmonary complications (p = 0.037) significantly differed based on the cognitive status. Operation time (p = 0.049), white blood cell count (p = 0.022), platelet count (p = 0.013), the mini-mental state examination score (p = 0.033), and the Beck Depression Inventory score (p = 0.041) were significantly associated with the length of hospital stay. Our investigation demonstrated that improved understanding of preoperative cognitive status may be helpful in surgical decision-making and postoperative care of elderly patients with degenerative spinal disease.

Highlights

Introduction iationsCognitive status is one of the most important perioperative risk factors related to clinical outcomes in geriatric patients [1,2]
Preoperative cognitive status has been linked to the incidence of other adverse outcomes, including postoperative complications, longer hospital stays, and functional decline [16,18]
As the frequency of spine surgery is increasing in parallel with the aging population and spinal degenerative diseases, a more comprehensive understanding of the relationship between preoperative cognitive status and clinical outcomes is important for predicting general prognosis and determining treatment plans following the spine surgery

Summary

Introduction

Introduction iationsCognitive status is one of the most important perioperative risk factors related to clinical outcomes in geriatric patients [1,2]. The elderly population has recently been increasing due to extended life expectancy, leading to an increase in the number of patients with degenerative spinal diseases and, the number of spine surgeries. Spine surgeons are managing an increasing number of elderly people with spinal disorders and aging of the spine [3,4,5,6]. These patients usually have an increased number of comorbidities, severe spinal degeneration, and reduced bone mineral density [7]. Impaired cognitive status is common in elderly patients. Preoperative cognitive status has been reported as Licensee MDPI, Basel, Switzerland

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