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Tytuł pozycji:

Association between perioperative blood transfusion and early postoperative cognitive dysfunction in aged patients following total hip replacement surgery

Tytuł :
Association between perioperative blood transfusion and early postoperative cognitive dysfunction in aged patients following total hip replacement surgery
Autorzy :
Zhu, Si-Hai
Ji, Mu-Huo
Gao, Da-Peng
Li, Wei-Yan
Yang, Jian-Jun
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Temat :
Original Article
hip replacement surgery
RBCs transfusion
postoperative cognitive dysfunction
Elderly
Źródło :
Upsala Journal of Medical Sciences
Wydawca :
Informa Healthcare, 2014.
Rok publikacji :
2014
Oryginalny identyfikator :
pmc: PMC4116766
pmid: 24345210
Język :
English
ISSN :
2000-1967
0300-9734
DOI :
10.3109/03009734.2013.873502
Introduction Accumulating evidence suggests that enhanced inflammatory responses contribute to the pathogenesis of postoperative cognitive dysfunction (POCD). Blood transfusion can trigger an enhancement of acute inflammatory responses. Therefore, we hypothesized that perioperative blood transfusion is associated with a higher risk of POCD in aged patients following total hip replacement surgery. Material and methods Patients older than 65 years undergoing elective total hip replacement surgery were enrolled from October 2011 to December 2012. Neurocognitive tests were evaluated at baseline and at 7 d after surgery by a Mini-Mental State Test. Multivariate logistic regression analysis was used to determine risk factors associated with POCD. Results Fifty-six patients (27.3%) developed POCD 7 d postoperatively. Patients who developed POCD were older, had a lower education level and preoperative hemoglobin concentration, had more blood loss, and had a lower body weight (p < 0.05). Patients with POCD were more likely to receive red blood cells (RBCs) transfusion (51.8% versus 31.5%; p < 0.05). A multivariable logistic regression model identified older age, lower education level, and perioperative blood transfusion of more than 3 units as independent risk factors for POCD 7 d postoperatively. Conclusion Our data suggested that perioperative blood transfusion of more than 3 units of RBCs is an independent risk factor for POCD in aged patients following total hip replacement surgery.
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