Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery-2018

被引：636

作者：

Evered, L. ^{[1
,2
]}

Silbert, B. ^{[1
,2
]}

Knopman, D. S. ^{[3
]}

Scott, D. A. ^{[1
,2
]}

DeKosky, S. T. ^{[4
]}

Rasmussen, L. S. ^{[5
]}

Oh, E. S. ^{[6
]}

Crosby, G. ^{[7
]}

Berger, M. ^{[8
]}

Eckenhoff, R. G. ^{[9
]}

机构：

[1] St Vincents Hosp, Fitzroy, Vic, Australia

[2] Univ Melbourne, Fitzroy, Vic, Australia

[3] Mayo Clin, Dept Neurol, Rochester, MN USA

[4] Univ Florida, McKnight Brain Inst, Dept Neurol, Gainesville, FL USA

[5] Univ Copenhagen, Dept Anaesthesia, Ctr Head & Orthopaed, Rigshosp, Copenhagen, Denmark

[6] Johns Hopkins Univ, Sch Med, Div Geriatr Med & Gerontol, Baltimore, MD USA

[7] Harvard Med Sch, Brigham & Womens Hosp, Boston, MA USA

[8] Duke Univ, Med Ctr, Dept Anesthesiol, Neurol Outcomes Res Grp, Durham, NC 27710 USA

[9] Univ Penn, Sch Med, Dept Anesthesiol & Crit Care, Philadelphia, PA 19104 USA

来源：

BRITISH JOURNAL OF ANAESTHESIA | 2018年 / 121卷 / 05期

关键词：

cognition disorders; delirium; neurocognitive disorders; postoperative complications; BYPASS GRAFT-SURGERY; CARDIAC-SURGERY; DIAGNOSTIC GUIDELINES; ALZHEIMERS-DISEASE; NATIONAL INSTITUTE; IMPAIRMENT; DYSFUNCTION; TERM; WORKGROUPS; DEMENTIA;

D O I：

10.1016/j.bja.2017.11.087

中图分类号：

R614 [麻醉学];

学科分类号：

100217 [麻醉学];

摘要：

Cognitive change affecting patients after anaesthesia and surgery has been recognised for more than 100 yr. Research into cognitive change after anaesthesia and surgery accelerated in the 1980s when multiple studies utilised detailed neuropsychological testing for assessment of cognitive change after cardiac surgery. This body of work consistently documented decline in cognitive function in elderly patients after anaesthesia and surgery, and cognitive changes have been identified up to 7.5 yr afterwards. Importantly, other studies have identified that the incidence of cognitive change is similar after non-cardiac surgery. Other than the inclusion of non-surgical control groups to calculate postoperative cognitive dysfunction, research into these cognitive changes in the perioperative period has been undertaken in isolation from cognitive studies in the general population. The aim of this work is to develop similar terminology to that used in cognitive classifications of the general population for use in investigations of cognitive changes after anaesthesia and surgery. A multispecialty working group followed a modified Delphi procedure with no prespecified number of rounds comprised of three face-to-face meetings followed by online editing of draft versions. Two major classification guidelines [Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM-5) and National Institute for Aging and the Alzheimer Association (NIA-AA)] are used outside of anaesthesia and surgery, andmay be useful for inclusion of biomarkers in research. For clinical purposes, it is recommended to use the DSM-5 nomenclature. The working group recommends that ` perioperative neurocognitive disorders ' be used as an overarching termfor cognitive impairment identified in the preoperative or postoperative period. This includes cognitive decline diagnosed before operation (described as neurocognitive disorder); any formof acute event (postoperative delirium) and cognitive decline diagnosed up to 30 days after the procedure (delayed neurocognitive recovery) and up to 12 months (postoperative neurocognitive disorder).

引用

页码：1005 / 1012

页数：8

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