Incidencia del déficit cognitivo postoperatorio en anestesia regional y general en una institución de cuarto nivel en Bucaramanga (Santander, Colombia) en el año 2017

dc.contributor.authorContreras Forero, Francisco Javier
dc.contributor.authorOchoa, Miguel Enrique
dc.contributor.authorPérez, Margarita
dc.contributor.authorPinillos, Mauricio
dc.contributor.authorCelis, Laura
dc.contributor.authorValencia Guampe, Jhon Sebastián
dc.contributor.authorDelgado Pascuaza, Angi Yaquely
dc.date.accessioned2024-07-22T22:07:40Z
dc.date.available2024-07-22T22:07:40Z
dc.date.issued2020-09-24
dc.description.abstractEn el proceso de envejecimiento, la mayoría de los sistemas orgánicos mantienen su funcionamiento basal, pero existe una reducción de la reserva funcional y de la capacidad para compensar el estrés fisiológico, lo que hace que los pacientes de mayor edad sean más propensos a complicaciones postoperatorias. Se realizó un estudio en instituciones de Bucaramanga para determinar la incidencia de déficit cognitivo postoperatorio y los factores de riesgo asociados. Metodología. Estudio observacional analítico de cohorte prospectivo realizado en instituciones de salud de Bucaramanga durante 2017 con pacientes mayores de 55 años intervenidos bajo anestesia regional, general balanceada o anestesia total intravenosa. Resultados. Se estudiaron 173 pacientes, 112 mujeres (64.74%) y 61 hombres (35.26%) operados. Las técnicas anestésicas más empleadas fueron: Regional (46.24%) y General balanceada (44.51%). La incidencia de Déficit Cognitivo Postoperatorio a corto plazo fue 6.36% en pacientes previamente sanos, con valor P significativo (0.001) ajustado. Se detectó deterioro cognitivo del 51.41% con alteraciones en los dominios de lenguaje, atención y memoria; con aumento en la evaluación a largo plazo. Durante el seguimiento de pacientes a largo plazo resultó en un 11.55%, determinando la incidencia de Déficit Cognitivo Postoperatorio tardío en un 17.91%. La técnica anestésica con mayor proporción de déficit a largo plazo fue la anestesia mixta, comparada con anestesia regional. Discusión. En la actualidad no existe una definición estandarizada de Déficit Cognitivo Postoperatorio, se ha observado mayor frecuencia y mayor prolongación en pacientes de edad avanzada. El estudio demostró una incidencia temprana significativamente menor, comparándolo con artículos internacionales, pero una incidencia mayor en déficit postoperatorio tardío, resultado de mayores complicaciones intraoperatorias, comparado con otros estudios. Conclusiones. El Déficit Cognitivo Postoperatorio involucra múltiples factores de riesgo; en el estudio se encontró mayor asociación con la edad, la escolaridad, la hipotensión y la anestesia general. No hubo asociación entre comorbilidades y el Déficit Cognitivo Postoperatorio. Se determinó la presencia de hipotensión para desarrollo de este déficit.spa
dc.description.abstractenglishWithin the aging process, most organic systems maintain their basal functions. However, there is a reduction in functional reserve and the capacity to compensate physiological stress, which makes older patients more prone to postoperative complications. A study was performed in institutions in Bucaramanga to determine the incidence of postoperative cognitive dysfunction and the associated risk factors. Methodology. This was a analytical observational prospective cohort study performed in healthcare institutions in Bucaramanga in 2017 with patients older than 55 years of age under regional, balanced general or total intravenous anesthesia. Results. One hundred and seventy-three operated patients were studied, among which 112 (64.74%) were women and 61 (35.26%) were men. The most commonly used anesthetic techniques were: regional (46.24%) and balanced general (44.51%). Short-term Postoperative Cognitive Dysfunction incidence was 6.36% in previously healthy patients, with an adjusted significant P value (0.001). Cognitive deterioration was detected in 51.41% of patients, with alterations in their mastery of language, attention and memory. This increased for the long-term evaluation. During long-term patient follow-up, it resulted in 11.55%, determining the incidence of delayed Postoperative Cognitive Dysfunction at 17.91%. The anesthetic technique with the highest proportion of long- term dysfunction was mixed anesthesia, compared to regional anesthesia. Discussion. There is currently no standardized definition for Postoperative Cognitive Dysfunction. It has been observed more frequently and for longer extensions in older patients. The study demonstrated a significantly lower early incidence when compared to international articles, but a greater incidence of delayed postoperative dysfunction as a result of more intraoperative complications compared to other studies. Conclusions. Postoperative Cognitive Dysfunction involves multiple risk factors. The study observed a greater association with age, level of education, hypotension and general anesthesia. There was no association between comorbidities and Postoperative Cognitive Dysfunction. The presence of hypotension was determined for developing this dysfunction.eng
dc.description.abstractotherNo processo de envelhecimento, a maioria dos sistemas orgânicos mantém seu funcionamento basal, mas há uma diminuição da reserva funcional e da capacidade de compensar o estresse fisiológico que torna os pacientes idosos mais sujeitos a complicações pós-operatórias. Foi realizado um estudo em instituições da cidade de Bucaramanga para determinar a incidência de déficit cognitivo pós-operatório e os fatores de risco associados. Métodos. Estudo observacional analítico de coorte prospectivo realizado em instituições de saúde em Bucaramanga durante o ano de 2017 em pacientes com idade superior a 65 anos operados sob anestesia regional, geral balanceada ou anestesia geral intravenosa. Resultados. Foram estudados 173 pacientes, 112 mulheres (64.74%) e 61 homens (35.26%) operados. As técnicas anestésicas mais utilizadas foram: regional (46.24%) e geral balanceada (44.51%). A incidência de déficit cognitivo pós-operatório de curto prazo foi de 6.36% em pacientes previamente saudáveis, com um valor P significativo (0.001) ajustado. Detectou- se deterioração cognitiva de 51.41% com alterações nos domínios da linguagem, atenção e memória; com aumento na avaliação de longo prazo. No seguimento a longo prazo dos pacientes resultou em 11.55%, determinando a incidência de déficit cognitivo pós-operatório tardio em 17.91%. A técnica anestésica com maior proporção de déficit no longo prazo foi a anestesia mista, em comparação com a anestesia regional. Discussão. Atualmente não existe uma definição padronizada de Déficit Cognitivo Pós-operatório, a qual observa-se com maior frequência e por mais tempo em pacientes idosos. O estudo demonstrou incidência precoce significativamente menor, em comparação com resultados de artigos internacionais, mas maior incidência de déficit pós-operatório tardio, resultado de maiores complicações intraoperatórias, em comparação com outros estudos. Conclusões. O Déficit Cognitivo Pós-operatório envolve múltiplos fatores de risco; o estudo encontrou maior associação com idade, escolaridade, hipotensão e anestesia geral. Não houve associação entre comorbidades e Déficit Cognitivo Pós-operatório. Determinou-se a presença de hipotensão para o desenvolvimento desse déficit.por
dc.format.mimetypeapplication/pdfspa
dc.identifier.doihttps://doi.org/10.29375/01237047.3711
dc.identifier.instnameinstname:Universidad Autónoma de Bucaramanga UNABspa
dc.identifier.issni-ISSN 0123-7047spa
dc.identifier.issne-ISSN 2382-4603spa
dc.identifier.reponamereponame:Repositorio Institucional UNABspa
dc.identifier.repourlrepourl:https://repository.unab.edu.cospa
dc.identifier.urihttp://hdl.handle.net/20.500.12749/25647
dc.language.isospaspa
dc.publisher.facultyFacultad Ciencias de la Saludspa
dc.publisher.grantorUniversidad Autónoma de Bucaramanga UNABspa
dc.relationhttps://revistas.unab.edu.co/index.php/medunab/article/view/3711/3351spa
dc.relation.referencesSieber FE, Barnett SR. Preventing postoperative complications in the elderly. Anesthesiology Clinics. 2011;29(1):83-97. Doi: https://doi.org/10.1016/j. anclin.2010.11.011
dc.relation.referencesInouye SK, Westendorp RG, Saczynski JS. Delirium in elderly people. Lancet. 2014;383:911-22. Doi:https:// doi.org/10.1016/S0140-6736(13)60688-1
dc.relation.referencesAgnoletti V, Ansaloni L, Catena F, Chattat R, De Cataldis A, Di Nino G, et al. Postoperative Delirium after elective and emergency surgery: analysis and checking of risk factors. A studyprotocol. BMC Surgery. 2005;5:12-18. Doi: https://doi. org/10.1186/1471-2482-5-12
dc.relation.referencesJohnson T, Monk T, Rasmussen LS, Abildstrom H, Houx P, Korttila K, et al. Postoperative cognitive dysfunction in middle-aged patients. Anesthesiology. 2002; 96:1351-7. Doi: https://doi. org/10.1097/00000542-200206000-00014
dc.relation.referencesNewman MF, Grocott HP, Mathew JP, White WD, Landolfo K, Reves JG, et al. Neurologic Outcome Research Group and the Cardiothoracic Anesthesia Research Endeavors (CARE) Investigators of the Duke Heart Center: Report of the substudy assessing the impact of neurocognitive function on quality of life 5 years after cardiac surgery. Stroke. 2001; 32:2874- 81. Doi: https://doi.org/10.1161/hs1201.099803
dc.relation.referencesPhillips-Bute B, Mathew JP, Blumenthal JA, Grocott HP, Laskowitz DT, Jones RH, et al. Association of neurocognitive function and quality of life 1 year after coronary artery bypass graft (CABG) surgery. Psychosom Med. 2006;68:369-75. Doi: https://doi. org/10.1097/01.psy.0000221272.77984.e2
dc.relation.referencesMonk TG, Weldon BC, Garvan CW, Dede DE, van der Aa MT, Heilman KM, et al. Predictors of cognitive dysfunction after major noncardiac surgery. Anesthesiology. 2008; 108:18-30. Doi: https://doi. org/10.1097/01.anes.0000296071.19434.1e
dc.relation.referencesSteinmetzJ,ChristensenKB,LundT,LohseN,Rasmussen LS. Long-term consequences of postoperative cognitive dysfunction. Anesthesiology. 2009;110(3):548-55. Doi: 10.1097/ALN.0b013e318195b569
dc.relation.referencesGuzmán V. Disfunción cognitiva postoperatoria en pacientes mayores de 50 años bajo anestesia general y regional. Estudio cohorte prospectivo. Biblioteca Virtual UIS.
dc.relation.referencesFolstein MF, Folstein SE, McHugh PR. ‘MiniMental State’: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12:189-198. Doi: https://doi.org/10.1016/0022- 3956(75)90026-6
dc.relation.referencesHorton AM, Slone DG, Shapiro S. Neuropsychometric correlates of the Mini-Mental State Examination: preliminary data. Percept Mot Skills. 1987; 65:64-66. Doi: https://doi.org/10.2466/pms.1987.65.1.64
dc.relation.referencesAnthony JC, LeResche L, Niaz U, Von Korff MR, Folstein MF. Limits of the ‘Mini-Mental State’ as a screening test for dementia and delirium among hospital patients. Psychol Med. 1982;12:397-408. Doi: https://doi.org/10.1017/S0033291700046730
dc.relation.referencesEvered L, Silbert B, Knopman DS, Scott DA, DeKosky T, Rasmussen LS, et al. Recommendations for the Nomenclature of Cognitive Change Associated with Anaesthesia and Surgery-2018. Anesthesiology. 2018;129(5):872-879. Doi: https://doi.org/10.1097/ ALN.0000000000002334
dc.relation.referencesTrzepacz PT, Van der Mast RC, Lindesay J, Rockwood K, MacDonald A. Pathophysiology of delirium. Delirium in old age [Internet]. Oxford University Press. 2002 [citado 19 de octubre de 2020];51-90. Recuperado a partir de: https://global. oup.com/academic/product/delirium-in-old-age 9780192632753?cc=co&lang=en&
dc.relation.referencesTsai T, Sands LP, Leung JM. An Update on Postoperative Cognitive Dysfunction. Advances in Anesthesia. 2010;28(1):269-284. Doi: https://doi. org/10.1016/j.aan.2010.09.003
dc.relation.referencesTsuang DW, Bird TD. Genetics of dementia. Medical Clinics of North American. 2002; 86:591-614. Doi: https://doi.org/10.1016/S0025-7125(02)00003-2
dc.relation.referencesHole A, Terjesen T, Brevik H. Epidural versus general anaesthesia for total hip arthroplasty in elderly patients. Acta Anaesthesiologica Scandinavica. 1980; 24:279- 287. Doi: https://doi.org/10.1111/j.1399-6576.1980. tb01549.x
dc.relation.referencesBerggren D, Gustafson Y, Eriksson B, Bucht G, Hansson LI, Reiz S, et al. Postoperative confusion after anesthesia in elderly patients with femoral neck fractures. Anesthesia&Analgesia Journal. 1987;66:497-504. Doi: https://doi. org/10.1213/00000539-198706000-00003
dc.relation.referencesWilliams-Russo P, Sharrock N, Mattis S, Szatrowski T, Charlson M. Cognitive effects after epidural vs general anesthesia in older adults. JAMA. 1995;274:44-50. Doi: https://doi.org/10.1001/ jama.1995.03530010058035
dc.relation.referencesRasmussenLS,LarsenK,HouxP,SkovgaardLT,Hanning CD, Möller JT. ISPOCD group. The International Study of Postoperative Cognitive Dysfunction. The assessment of postoperative cognitive function. Acta Anaesthesiologica Scandinavica. 2001;45:275-89. Doi: https://doi.org/10.1034/j.1399-6576.2001.045003275.x
dc.relation.referencesTaylor D, Lewis S. Delirium. Journal of Neurology, Neurosurgery & Psychiatry. 1993;56:742-751. Doi: https://doi.org/10.1136/jnnp.56.7.742
dc.relation.referencesCarrillo-Esper R, Peña-Pérez CA, Gómez-Hernández K, Carrillo-Córdova LD, Villena-López EL. Disfunción cognitiva postoperatoria. RevInvestMed Sur (Mex) [Internet]. 2012 [citado 19 de octubre de 2016];19(3):163-169. Recuperado a partir de: https://www.medigraphic.com/cgi-bin/new/resumen. cgi?IDARTICULO=41961
dc.relation.referencesYoon-Sik O. Incidence and risk factors of acute postoperative delirium in geriatric neurosurgical patients. Journal of KoreanNeurosurgical Society. 2008;43:143-148. Doi: https://doi.org/10.3340/ jkns.2008.43.3.143
dc.relation.referencesFolstein MF, Folstein SE, McHugh PR. ‘MiniMental State a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189-198. Doi: https://doi.org/10.1016/0022- 3956(75)90026-6
dc.relation.referencesHorton AM, Slone DG, Shapiro S. Neuropsychometric correlates of the MiniMental State Examination: preliminary data. Percept Mot Skills. 1987;65:64-66. Doi: https://doi.org/10.2466/pms.1987.65.1.64
dc.relation.referencesGauthier S, Bouchard R, Lamontagne A, Bailey P, Bergman H, Ratner J, et al. Tetrahydroaminoacridine- lecithin combination treatment in patients with intermediate-stage Alzheimer’s disease: results of a Canadian doubleblind, crossover, multicenter study. N Engl J Med. 1990;322:1272-1276. Doi: https://doi. org/10.1056/NEJM199005033221804
dc.relation.referencesRosselli D, Ardila A, Pradilla G, Morillo L, et al. The mini-mental state examination as a diagnostic selection test for dementia: a colombian population study. Rev Neurol 2000; 30 (5): 428-432. https://doi. org/10.33588/rn.3005.99125
dc.relation.referencesDokkedal U, Hansen TG, Rasmussen LS, Mengel- From J, Christensen K. Cognitive functioning after surgery in middle-aged and elderly Danish twins. Anesthesiology. 2016;124:312-21. Doi: https://doi. org/10.1097/ALN.0000000000000957
dc.relation.referencesLobo F. Anestesia, demencias y enfermedad de Alzheimer: ¿coincidencia o certeza? Rev Argent Anestesiol [Internet] . 2012 [Citado 19 de octubre de 2020];70:91-6. Recuperado a partir de: https://www.anestesia.org.ar/search/articulos_ completos/1/1/1442/c.pdf
dc.relation.referencesDeiner S, Silverstein JH. Postoperative delirium and cognitive dysfunction. British Journal of Anaesthesia. 2009;103(Suppl.1):i41-i46. Doi: https://doi. org/10.1093/bja/aep291
dc.relation.referencesAvidan MS, Evers AS. Review of clinical evidence for persistent cognitive decline or incident dementia attributable to surgery or general anesthesia. Journal of Alzheimer’s Disease. 2011;24(2):201-16. Doi: https://doi.org/10.3233/JAD-2011-101680
dc.relation.referencesRundshagen I. Postoperative cognitive dysfunction. Deutsches Arzteblatt international. 2014;111(8):119- 125. Doi: https://doi.org/10.3238/arztebl.2014.0119
dc.relation.referencesCulley DJ, Baxter MG, Crosby CA, Yukhananov R, Crosby G. Impaired acquisition of spatial memory 2 weeks after isoflurane and isoflurane- nitrous oxide anesthesia in aged rats. Anesthesia&Analgesia Journal. 2004;99:1393-1397. Doi: https://doi. org/10.1213/01.ANE.0000135408.14319.CC
dc.relation.referencesShors TJ, Miesegaes G, Beylin A, Zhao M, Rydel T, Gould E. Neurogenesis in the adult is involved in the formation of trace memories. Nature. 2001;410:372- 376. Doi: https://doi.org/10.1038/35066584
dc.relation.referencesLira D, Mar-Meza M, Montesinos R, Herrera-Pérez E, Cuenca J, Castro-Suárez S, et al. Una complicación quirúrgica escasamente sospechada: la disfunción cognitiva postoperatoria. Rev Neuropsiquiatria. 2018;81(2):113. Doi: https://doi.org/10.20453/rnp. v81i2.3339
dc.relation.referencesAn J, Fang Q, Huang C, Qian X, Fan T, Lin Y, et al. Deeper Total Intravenous Anesthesia Reduced the Incidence of Early Postoperative Cognitive Dysfunction After Microvascular Decompression for Facial Spasm. Journal of Neurosurgical Anesthesiology. 2011;23(1):12-7. Doi: https://doi. org/10.1097/ANA.0b013e3181f59db4
dc.relation.referencesChan M, Cheng P, Lee T, Gin T. BIS-guidedAnesthesia Decreases Postoperative Delirium and Cognitive Decline. Journal of Neurosurgical Anesthesiology. 2013;25(1):33-42. Doi: https://doi.org/10.1097/ ANA.0b013e3182712fba
dc.relation.referencesCanet J, Raeder J, Rasmussen LS, Enlund M, Kuipers HM, Hanning CD, et al. Cognitive dysfunction after minor surgery in the elderly. Acta anaestheesiol Scand 2003;47:1204-1210. Doi: https://doi.org/10.1046/ j.1399-6576.2003.00238.x
dc.relation.urihttps://revistas.unab.edu.co/index.php/medunab/issue/view/264spa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadas 2.5 Colombia*
dc.rights.localAbierto (Texto Completo)spa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/*
dc.sourceVol. 23 Núm. 3 (2020): diciembre 2020 - marzo 2021: Depresión, Infecciones Urinarias, Agotamiento Profesional; 450-463spa
dc.subjectDéficit Cognitivo Postoperatoriospa
dc.subjectDisfunción cognitivaspa
dc.subjectIncidenciaspa
dc.subjectAnestesia intravenosaspa
dc.subjectAnestesia generalspa
dc.subjectAnestesia balanceadaspa
dc.subject.keywordsMedical scienceseng
dc.subject.keywordsLife scienceseng
dc.subject.keywordsPostoperative cognitive dysfunctioneng
dc.subject.keywordsCognitive dysfunctioneng
dc.subject.keywordsIncidenceeng
dc.subject.keywordsIntravenous anesthesiaeng
dc.subject.keywordsGeneral anesthesiaeng
dc.subject.keywordsBalanced anesthesiaeng
dc.subject.keywordsDéficit Cognitivo Pós-operatóriopor
dc.subject.keywordsDisfunção cognitivapor
dc.subject.keywordsIncidênciapor
dc.subject.keywordsAnestesia intravenosapor
dc.subject.keywordsAnestesia geralpor
dc.subject.keywordsAnestesia balanceadapor
dc.subject.keywordsMedical scienceseng
dc.subject.keywordsLife scienceseng
dc.subject.keywordsHealth scienceseng
dc.subject.keywordsCiências médicaspor
dc.subject.keywordsCiências da vidapor
dc.subject.keywordsCiências da saúdepor
dc.subject.lembCiencias médicasspa
dc.subject.lembCiencias de la vidaspa
dc.subject.proposalCiencias de la saludspa
dc.titleIncidencia del déficit cognitivo postoperatorio en anestesia regional y general en una institución de cuarto nivel en Bucaramanga (Santander, Colombia) en el año 2017spa
dc.title.translatedPostoperative cognitive dysfunction incidence for regional and general anesthesia in a level four institution in Bucaramanga (Santander, Colombia) during 2017eng
dc.title.translatedIncidência do déficit cognitivo pós-operatório em anestesia regional e geral em uma instituição de quarto nível em Bucaramanga (Santander, Colômbia) em 2017por
dc.typeArticleeng
dc.type.coarhttp://purl.org/coar/resource_type/c_2df8fbb1
dc.type.coarversionhttp://purl.org/coar/version/c_ab4af688f83e57aaspa
dc.type.driverinfo:eu-repo/semantics/article
dc.type.hasversioninfo:eu-repo/semantics/publishedVersion
dc.type.localArtículospa
dc.type.redcolhttp://purl.org/redcol/resource_type/ART

Archivos

Bloque original

Mostrando 1 - 1 de 1
Cargando...
Miniatura
Nombre:
Artículo.pdf
Tamaño:
1.04 MB
Formato:
Adobe Portable Document Format
Descripción:
Artículo

Bloque de licencias

Mostrando 1 - 1 de 1
Cargando...
Miniatura
Nombre:
license.txt
Tamaño:
183 B
Formato:
Item-specific license agreed upon to submission
Descripción:

Colecciones