Correlation Between Frailty And Perioperative Neurocognitive Dysfunction In Elderly Patients

Objective: To analyze the differences in perioperative brain function indicators between Frail and Non-Frail elderly patients,and to explore the correlation between frailty and perioperative neurocognitive dysfunction in elderly patients.Methods: Using the casecontrol method,100 patients(average age,72.03±6.23 years old)who met the inclusion and exclusion criteria who were scheduled to undergo surgery in our hospital from November 2021 to November 2022 were selected,and were divided into two groups,the Frailty group(Case group)and the Non-Frail group(Control group);the Montreal Cognitive Assessment(Mo CA)was used to assess cognitive function on the 1st day before operation and the 3rd day after operation respectively;both groups were under general anesthesia For surgical treatment,use the Masio cerebral oxygen monitor to monitor intraoperative brain function-related indicators(PSI,SEF),and recording three time point of data when entering the operating room(T1),anesthesia maintenance period(T2),and after extubation(T3);Collect relevant information and analyze data.Results:(1)There were 50 cases in the Frail group,with an average age of(73.68±6.23)years;50 cases in the Non-Frail group,with an average age of(70.38±5.84)years,and there was a difference in age between the two groups(P<0.05).(2)The proportion of comorbidities(≥5 types),years of education(≤12 years),and intraoperative vasoactive drugs in the Frail group were higher than those in the Non-Frail group(P<0.05);There were no significant differences in Gender,ASA classification,BMI,Marital widowhood,and Sleep disorders(P>0.05).(3)The brain function indexes(PSI,SEF)of the Frail group were lower than those of the NonFrail group before operation,anesthesia maintenance period,and after extubation(P<0.05).(4)The preoperative and postoperative Mo CA scores of the Frail group were significantly lower than those of the Non-Frail group(P<0.05);the preoperative Mo CA score of the Frail group was higher than the postoperative Mo CA score(P<0.05),and there was no significant difference between the preoperative Mo CA score and the postoperative Mo CA score of the Non-Frail group(P>0.05).(5)The incidence of perioperative neurocognitive dysfunction in the Frailty group(32%)was higher than that in the Non-Frailty group(14%),and there was a statistical difference between the two groups(P>0.05).The incidence of perioperative neurocognitive decline in the Frailty group(52%)was higher than that in the Non-Frail group(24%),and there was a statistical difference between the two groups(P>0.05)。(6)The SEF values of FP group and NFP group before operation,anesthesia maintenance period,and after extubation were lower than those of the other two groups,and there were statistical differences among the groups(P>0.05).Conclusion:(1)Age,low education level(≤12 years),and comorbidity(≥5 kinds)are important influencing factors of frailty;(2)There is a positive correlation between frailty in elderly patients and the decline of perioperative brain function indicators(PSI,SEF),and it is also positively correlated with perioperative neurocognitive dysfunction(decline);(3)Frailty combined Cerebral function index monitoring(SEF)can provide a basis for predicting the occurrence of perioperative neurocognitive dysfunction.