Postoperative cognitive dysfunction: a concept analysis.

IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Aging Clinical and Experimental Research Pub Date : 2024-06-21 DOI:10.1007/s40520-024-02779-7
Hesam Aldin Varpaei, Kousha Farhadi, Mostafa Mohammadi, Alireza Khafaee Pour Khamseh, Tahereh Mokhtari
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Abstract

Background: Post-operative cognitive dysfunction (POCD) is a concern for clinicians that often presents post-surgery where generalized anesthesia has been used. Its prevalence ranges from 36.6% in young adults to 42.4% in older individuals. Conceptual clarity for POCD is lacking in the currently body literature. Our two-fold purpose of this concept analysis was to (1) critically appraise the various definitions, while also providing the best definition, of POCD and (2) narratively synthesize the attributes, surrogate or related terms, antecedents (risk factors), and consequences of the concept.

Method: The reporting of our review was guided by the PRISMA statement and the 6-step evolutionary approach to concept analysis developed by Rodgers. Three databases, including Medline, CINAHL, and Web of Science, were searched to retrieve relevant literature on the concept of POCD. Two independent reviewers conducted abstract and full-text screening, data extraction, and appraisal. The review process yielded a final set of 86 eligible articles.

Result: POCD was defined with varying severities ranging from subtle-to-extensive cognitive changes (1) affecting single or multiple cognitive domains that manifest following major surgery (2), is transient and reversible, and (3) may last for several weeks to years. The consequences of POCD may include impaired quality of life, resulting from withdrawal from the labor force, increased patients' dependencies, cognitive decline, an elevated risk of dementia, rising healthcare costs, and eventual mortality.

Conclusion: This review resulted in a refined definition and comprehensive analysis of POCD that can be useful to both researchers and clinicians. Future research is needed to refine the operational definitions of POCD so that they better represent the defining attributes of the concept.

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术后认知功能障碍:概念分析。
背景:术后认知功能障碍(POCD)是临床医生关注的一个问题,通常在使用全身麻醉的手术后出现。其发病率从年轻人的 36.6% 到老年人的 42.4% 不等。在目前的文献中,POCD 的概念还不够清晰。我们进行概念分析的双重目的是:(1)批判性地评估 POCD 的各种定义,同时提供最佳定义;(2)叙述性地综合 POCD 的属性、替代或相关术语、前因(风险因素)和后果:我们的综述报告以 PRISMA 声明和罗杰斯提出的概念分析 6 步演进法为指导。我们搜索了三个数据库,包括 Medline、CINAHL 和 Web of Science,以检索 POCD 概念的相关文献。两位独立审稿人进行了摘要和全文筛选、数据提取和评估。审查过程最终产生了 86 篇符合条件的文章:结果:POCD 的定义有轻重之分,从细微到广泛的认知变化(1)影响单个或多个认知领域,在大手术后表现出来(2),是短暂的、可逆的,(3)可能持续数周至数年。POCD 的后果可能包括生活质量受损、退出劳动力市场、患者依赖性增加、认知能力下降、痴呆风险增加、医疗费用增加以及最终死亡:本综述对 POCD 进行了完善的定义和全面的分析,对研究人员和临床医生都很有用。未来的研究需要完善 POCD 的操作定义,使其更好地代表这一概念的定义属性。
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来源期刊
CiteScore
7.90
自引率
5.00%
发文量
283
审稿时长
1 months
期刊介绍: Aging clinical and experimental research offers a multidisciplinary forum on the progressing field of gerontology and geriatrics. The areas covered by the journal include: biogerontology, neurosciences, epidemiology, clinical gerontology and geriatric assessment, social, economical and behavioral gerontology. “Aging clinical and experimental research” appears bimonthly and publishes review articles, original papers and case reports.
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