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Curr Opin Anaesthesiol · Jun 2022
ReviewRisk assessment of perioperative neurocognitive disorders, where are we now?
- Martin Soehle and Mark Coburn.
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany.
- Curr Opin Anaesthesiol. 2022 Jun 1; 35 (3): 409418409-418.
Purpose Of ReviewPerioperative neurocognitive disorders (PNDs) are among the most frequent complications after surgery and are associated with considerable morbidity and mortality. We analysed the recent literature regarding risk assessment of PND.Recent FindingsCertain genetic variants of the cholinergic receptor muscarinic 2 and 4, as well as a marked degree of frailty but not the kind of anaesthesia (general or spinal) are associated with the risk to develop postoperative delirium (POD). Models predict POD with a discriminative power, for example, area under the receiver operating characteristics curve between 0.52 and 0.94.SummaryAdvanced age as well as preexisting cognitive, functional and sensory deficits remain to be the main risk factors for the development of PND. Therefore, aged patients should be routinely examined for both preexisting and new developing deficits, as recommended in international guidelines. Appropriate tests should have a high discrimination rate, be feasible to be administered by staff that do not require excessive training, and only take a short time to be practical for a busy outpatient clinic. Models to predict PND, should be validated appropriately (and externally if possible) and should not contain a too large number of predictors to prevent overfitting of models.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
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