• Dongxu Chen, Jiao Chen, Hui Yang, Xiao Liang, Yuxuan Xie, Shiyue Li, Lin Ding, and Qian Li.
• Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China.
• Minerva Anestesiol. 2019 Nov 1; 85 (11): 1193-1200.

BackgroundThe aim of this study was to examine whether preoperative Mini-Cog testing can predict postoperative mortality in geriatric patients undergoing general surgery.MethodsThe study enrolled elderly patients (at least 65 years of age) scheduled to receive general surgery under general anesthesia between October 2015 and December 2017. Mini-Cog scores ≤2 were considered abnormal and indicative of probable cognitive impairment. All-cause mortality at one-year was compared between patients with normal or abnormal preoperative Mini-Cog scores.ResultsA total of 551 patients (333 women) were included in the study with a mean age of 71 years (SD, 7), and 183 (33.2%) patients had preoperative Mini-Cog scores ≤2. The one-year all-cause mortality rate was 18.0% for the study population, and was significantly higher in the cognitive impairment group (24.0%) than the normal group (15.0%, P=0.009). Kaplan-Meier survival analysis revealed significantly higher one-year mortality among those with cognitive impairment (log-rank, P=0.008), even after adjustment for confounding factors (hazards ratio 1.6, 95% CI: 1.1 to 2.4; P=0.03). The two groups did not differ significantly in the incidence of postoperative complications (13.0% vs. 13.7%, P=0.894), length of hospital stay (10.2±7.4 vs. 10.4±8.3 days, P=0.136), or the need of Intensive Care Unit stay after surgery (14.8% vs. 11.7%, P=0.308).ConclusionsMini-Cog can be used to identify geriatric patients at risk of increased one-year mortality following elective surgery.

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