Preoperative Assessment Of Cognitive Function And Risk Assessment Of Cognitive Impairment In Elderly Patients With Orthopedics

Background:Preexisting cognitive impairment is emerging as a predictor of poor postoperative outcomes in seniors.Nevertheless,cognitive impairment in a large proportion of geriatric patients has not been well identified and diagnosed.Methods:This is a cross-sectional study.Mini-mental state examination scale was used to assess cognitive function of elderly patients undergoing orthopaedic elective surgery preoperatively.According to the assessment criteria,they were divided into cognitive normal group and cognitive impairment group.The baseline,living habits and laboratory examination results of the two groups were compared,and multivariate Logistic regression model was used to identify independent predictors of preoperative cognitive impairment.Results:A total of 374 elderly patients with orthopedics met the inclusion criteria,and 28.61%had preoperative cognitive impairment.Multivariate Logistic regression analysis showed that age(OR=1.090,P<0.001)and highest level of education(Compared with illiterate group,primary school group:OR=-O.916,P=0.007;middle school or higher group:OR=-2.188,P<0.001),subjective sleep disorder(OR=2.183,P=0.009),atherosclerosis(OR=2.673,P=0.008),high cholesterol level(OR=1.371,P=0.028)were independent risk factors for preoperative cognitive impairment.In addition,patients in cognitive impairment group had higher PSQI scores(P=0.038)and more with PSQI>7(P=0.004).Conclusions:The prevalence of preoperative cognitive dysfunction in geriatric elective orthopedic surgical patients was about 28.61%according to MMSE.Our study identified age,low level of education,subjective sleep disorder,atherosclerosis,high cholesterol level as risk factors for preoperative cognitive impairment in these patients.Understanding these risk factors contribute to assist in prevention and directed interventions for the high-risk population.