El deterioro cognitivo como factor de riesgo del delirium postoperatorio en la cirugía cardiaca basado en el Mini Mental State Examination, en personas mayores de 60 años: una revisión sistemática

Introduction

Delirium is a neurocognitive disorder whose prevalence increases with age. Its incidence after cardiac surgery ranges between 11% and 52%. There are a large number of studies on the risk factors that affect the appearance of postoperative delirium in cardiac surgery, although most of them are oriented to physiological factors, often ignoring the possible relevance of neuropsychological aspects, such as cognitive impairment. The objective of this work was to analyze the influence of cognitive impairment as an independent risk factor (predictor) in the appearance of postoperative delirium based on the Mini Mental State Examination (MMSE), after cardiac surgery.

Development

A search was carried out in the databases PubMed, PsycInfo, Scopus and Web of Science. The search was limited to articles published between 2001 and 2022. 384 articles were obtained. Those that were repeated and not related to the topic were eliminated, leaving a total of 8 articles that met the selection criteria. This systematic review was carried out in accordance with the criteria of the PRISMA 2020 statement.

Conclusions

A statistically significant correlation was observed between the measure of cognitive impairment, the MMSE, and the different measures of postoperative delirium, in the majority of studies, so it can be concluded that possibly a mild degree of cognitive impairment may be a sufficient condition for the probability of appearance of postoperative delirium in cardiac surgeries in patients over 60 years of age. Therefore, assessment of cognitive impairment using MMSE before cardiac surgery could be useful to predict the development of postoperative delirium in people over 60 years of age.