• Health Qual Life Out · Feb 2021

    Health-related quality of life and self-reported cognitive function in patients with delayed neurocognitive recovery after radical prostatectomy: a prospective follow-up study.

    • Ursula Kahl, Sarah Callsen, Stefanie Beck, Hans Pinnschmidt, Franziska von Breunig, Alexander Haese, Markus Graefen, Christian Zöllner, and Marlene Fischer.
    • Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
    • Health Qual Life Out. 2021 Feb 25; 19 (1): 64.

    BackgroundDelayed neurocognitive recovery (DNCR) is a common and serious complication after radical prostatectomy. We hypothesized that patients with DNCR in the early postoperative period would report reduced health-related quality of life (HRQoL) and more cognitive failures 12 months after surgery, compared with patients without DNCR.MethodsWe performed a 12-month follow-up on 367 patients who had been enrolled in a prospective observational trial to study the incidence of DNCR after radical prostatectomy. Patients were screened for preoperative cognitive impairment and depression. We defined DNCR as a decline in cognitive function between days 3 and 5 after surgery, compared with baseline assessments. We evaluated HRQoL and cognitive failures 12 months after surgery with the 36-item Short Form Health Survey and the Cognitive Failures Questionnaire. General linear models were used to analyze associations of DNCR with HRQoL and cognitive failures.ResultsDelayed neurocognitive recovery in the early postoperative period was significantly associated with self-reported cognitive failures (B for no DNCR =  - 0.411 [95% CI: - 0.798;0.024], p = 0.038), but not with physical (B = 0.082 [95% CI: - 0.021;0.186], p = 0.118) or mental HRQoL (B =  - 0.044 [95% CI: - 0.149;0.062], p = 0.417) 12 months after surgery. Preoperative depression screening scores were significantly associated with self-reported cognitive failures and both physical and mental HRQoL 12 months after surgery.ConclusionsDelayed neurocognitive recovery in the early period after radical prostatectomy has a long-term impact on patients' daily lives by impairing memory, attention, action, and perception. Therefore, prevention of DNCR must be a priority for physicians and researchers. Consequent preoperative screening for depressive symptoms may facilitate early psycho-oncological intervention to improve postoperative HRQoL. Trials registration DRKS00010014 , date of registration: 21.03.2016, retrospectively registered.

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