Min Li1, Ming Liu2, Chaofeng Li3, Guochao Zhang3, Yuan Wei4, Yun Xu5, Tao Li6. 1. Emergency Department, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China. 2. Beijing University of Chinese Medicine, Beijing, China. 3. Department of Gastrointestinal Surgery, China-Japan Friendship Hospital, Beijing, China. 4. Neurology Department, China-Japan Friendship Hospital, Beijing, China. 5. Geriatrics Department, China-Japan Friendship Hospital, Beijing, China. 6. Surgery Intensive Care Unit, China-Japan Friendship Hospital, Beijing, China. littlestudy@126.com.
Abstract
BACKGROUND: Although many reports have shown that preoperative dementia affects surgical prognosis, it is unclear whether the dementia based on Mini-Mental State Examination (MMSE) affect hospital mortality in old old patients undergoing elective gastrointestinal surgery. AIMS: This study aims to investigate whether preoperative dementia might affect the outcomes of old old patients undergoing elective gastrointestinal surgery by evaluating with the MMSE. METHODS: All patients aged ≥ 75 years who undergoing elective gastrointestinal surgery form January 2015 to December 2021 in a Chinese tertiary hospital were retrospectively analyzed. Their preoperative cognitive status was evaluated using the MMSE, and analysis was performed to compare the patients with MMSE score < 24 (dementia group) or MMSE score 24-30 (non-dementia group). Risk factors for hospital mortality were explored using multivariate logistic regression analysis. RESULTS: 980 patients were rolled in the study, and 102 (10.4%) patients were in the dementia group. ICU and hospital stay were longer in the dementia group. Regarding the postoperative complications, the incidence of cerebral infarction (P = 0.014), delirium (P = 0.019), and pulmonary infection (P = 0.017) was more frequent in dementia group. Hospital mortality was 11% in the dementia group and 3% in the non-dementia group (P = 0.009). Multivariate logistic regression analysis revealed that dementia (P = 0.0135), preoperative lower albumin (P = 0.0018) and malignancy (P = 0.0212) were independent risk factors for hospital mortality. CONCLUSIONS: Among old old patients undergoing elective gastrointestinal surgery, hospital mortality was increased significantly for patients with dementia evaluating with the MMSE.
BACKGROUND: Although many reports have shown that preoperative dementia affects surgical prognosis, it is unclear whether the dementia based on Mini-Mental State Examination (MMSE) affect hospital mortality in old old patients undergoing elective gastrointestinal surgery. AIMS: This study aims to investigate whether preoperative dementia might affect the outcomes of old old patients undergoing elective gastrointestinal surgery by evaluating with the MMSE. METHODS: All patients aged ≥ 75 years who undergoing elective gastrointestinal surgery form January 2015 to December 2021 in a Chinese tertiary hospital were retrospectively analyzed. Their preoperative cognitive status was evaluated using the MMSE, and analysis was performed to compare the patients with MMSE score < 24 (dementia group) or MMSE score 24-30 (non-dementia group). Risk factors for hospital mortality were explored using multivariate logistic regression analysis. RESULTS: 980 patients were rolled in the study, and 102 (10.4%) patients were in the dementia group. ICU and hospital stay were longer in the dementia group. Regarding the postoperative complications, the incidence of cerebral infarction (P = 0.014), delirium (P = 0.019), and pulmonary infection (P = 0.017) was more frequent in dementia group. Hospital mortality was 11% in the dementia group and 3% in the non-dementia group (P = 0.009). Multivariate logistic regression analysis revealed that dementia (P = 0.0135), preoperative lower albumin (P = 0.0018) and malignancy (P = 0.0212) were independent risk factors for hospital mortality. CONCLUSIONS: Among old old patients undergoing elective gastrointestinal surgery, hospital mortality was increased significantly for patients with dementia evaluating with the MMSE.
Authors: Evandro F Fang; Chenglong Xie; Joseph A Schenkel; Chenkai Wu; Qian Long; Honghua Cui; Yahyah Aman; Johannes Frank; Jing Liao; Huachun Zou; Ninie Y Wang; Jing Wu; Xiaoting Liu; Tao Li; Yuan Fang; Zhangming Niu; Guang Yang; Jiangshui Hong; Qian Wang; Guobing Chen; Jun Li; Hou-Zao Chen; Lin Kang; Huanxing Su; Brian C Gilmour; Xinqiang Zhu; Hong Jiang; Na He; Jun Tao; Sean Xiao Leng; Tanjun Tong; Jean Woo Journal: Ageing Res Rev Date: 2020-09-21 Impact factor: 10.895
Authors: Sam T Creavin; Susanna Wisniewski; Anna H Noel-Storr; Clare M Trevelyan; Thomas Hampton; Dane Rayment; Victoria M Thom; Kirsty J E Nash; Hosam Elhamoui; Rowena Milligan; Anish S Patel; Demitra V Tsivos; Tracey Wing; Emma Phillips; Sophie M Kellman; Hannah L Shackleton; Georgina F Singleton; Bethany E Neale; Martha E Watton; Sarah Cullum Journal: Cochrane Database Syst Rev Date: 2016-01-13
Authors: Michał Pędziwiatr; Judene Mavrikis; Jan Witowski; Alexandros Adamos; Piotr Major; Michał Nowakowski; Andrzej Budzyński Journal: Med Oncol Date: 2018-05-09 Impact factor: 3.064