Valoración de los trastornos neurocognitivos postoperatorios en estudios clínicos: revisión exploratoria

Contenido principal del artículo

Diego Fernando Rojas Gualdrón
https://orcid.org/0000-0002-2293-0431
Manuela Restrepo Botero
https://orcid.org/0000-0002-0071-4439
Tomás Múnera García
https://orcid.org/0000-0002-8946-210X
Juan Jose Amaya Alviar
https://orcid.org/0000-0001-5163-3199
Juliana Barrera Agudelo
https://orcid.org/0000-0002-0457-8462
Diana Restrepo Bernal
https://orcid.org/0000-0001-8555-6021

Resumen

Objetivo: analizar las definiciones empleadas en estudios clínicos para valorar la recuperación neurocognitiva demorada (RNCd) y los trastornos neurocognitivos menor y mayor postoperatorio (TNCp). Materiales y métodos: revisión exploratoria de la literatura. Se incluyeron estudios clínicos sobre los efectos de la anestesia y cirugía en términos de trastorno neurocognitivo postoperatorio publicados a partir del año 2013 en revistas indizadas en Pubmed o Scopus. Se realizó análisis crítico de los métodos de medición tomando como referencia los criterios planteados en el consenso de nomenclatura. Resultados: se identificaron 13 estudios, cuatro ensayos clínicos aleatorizados y nueve estudios observacionales. Solo tres de estos estudios emplearon definiciones consistentes con el consenso para la RNCd o TNCp. Las principales razones de no adherencia fueron los tiempos de medición y la no exclusión del delirium u otros trastornos mentales como explicación del declive cognitivo. Conclusión: pese a asumir la nomenclatura de trastornos neurocognitivos perioperatorios, los estudios fallaron en adherirse a los tiempos y criterios diagnósticos. Proponemos el desarrollo de un Core Outcome Set como estrategia para avanzar en el propósito de desarrollar evidencia más homogénea, de alta calidad y relevante para la toma de decisiones clínicas.

Descargas

Los datos de descargas todavía no están disponibles.

Detalles del artículo

Sección
Artículos de Investigación

Citas

Kotekar N, Shenkar A, Nagaraj R. Postoperative cognitive dysfunction- current preventive strategies. Clinical

Interventions in Aging. noviembre de 2018;Volume 13:2267-2273. DOI: http://dx.doi.org/10.2147/CIA.S133896

Borozdina A, Qeva E, Cinicola M, Bilotta F. Perioperative cognitive evaluation. Curr Opin Anaesthesiol.

;31(6):7567–7571. DOI: http://dx.doi.org/10.1097/ACO.0000000000000658

Mahanna-Gabrielli E, Schenning KJ, Eriksson LI, Browndyke JN, Wright CB, Culley DJ, et al. State of the clinical

science of perioperative brain health: report from the American Society of Anesthesiologists Brain Health

Initiative Summit 2018. Br J Anaesth. 2019;123(4):464–478. DOI: http://dx.doi.org/10.1016/j.bja.2019.07.004

Evered L, Silbert B, Knopman DS, Scott DA, DeKosky ST, Rasmussen LS, et al. Recommendations for the

Nomenclature of Cognitive Change Associated with Anaesthesia and Surgery—2018. Anesthesiology.

;129(5):872–879. DOI: http://dx.doi.org/10.1097/ALN.0000000000002334

Dhakal A, Bobrin BD. Cognitive Deficits. En: StatPearls. Treasure Island (FL): StatPearls Publishing; 2021

[citado 23 de agosto de 2021]. Disponible en: http://www.ncbi.nlm.nih.gov/books/NBK559052/

Sachdev PS, Blacker D, Blazer DG, Ganguli M, Jeste DV, Paulsen JS, et al. Classifying neurocognitive disorders: the DSM-5 approach. Nat Rev Neurol. 2014;10(11):634–642.

DOI: http://dx.doi.org/10.1038/nrneurol.2014.181

Wiggins M, Arias F, Urman RD, Richman DC, Sweitzer BJ, Edwards AF, et al. Common neurodegenerative

disorders in the perioperative setting: Recommendations for screening from the Society for Perioperative

Assessment and Quality Improvement (SPAQI). Perioper Care Oper Room Manag. 2020;20:100092.

DOI: http://dx.doi.org/10.1016/j.pcorm.2020.100092

Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis. JBI, 2020.

DOI: https://doi.org/10.46658/JBIMES-20-01

Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews

(PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467.

DOI: http://dx.doi.org/10.7326/M18-0850

American Psychiatric Association (2014). Manual diagnóstico y estadístico de los trastornos mentales DSM-5

(5a. ed.). Madrid: Editorial Médica Panamericana.

Li Y, Chen D, Wang H, Wang Z, Song F, Li H, et al. Intravenous versus Volatile Anesthetic Effects on Postoperative Cognition in Elderly Patients Undergoing Laparoscopic Abdominal Surgery. Anesthesiology.

;134(3):381–394. DOI: http://dx.doi.org/10.1097/ALN.0000000000003680

Zhang Y, Shan G-J, Zhang Y-X, Cao S-J, Zhu S-N, Li H-J, et al. Propofol compared with sevoflurane general

anaesthesia is associated with decreased delayed neurocognitive recovery in older adults. Br J Anaesth.

;121(3):595–604. DOI: http://dx.doi.org/10.1016/j.bja.2018.05.059

Li M-Y, Chen C, Wang Z-G, Ke J-J, Feng X-B. Effect of Nalmefene on Delayed Neurocognitive Recovery in

Elderly Patients Undergoing Video-assisted Thoracic Surgery with One Lung Ventilation. Curr Med Sci.

;40(2):380–388. DOI: http://dx.doi.org/10.1007/s11596-020-2170-8

Knaak C, Vorderwülbecke G, Spies C, Piper SK, Hadzidiakos D, Borchers F, et al. C-reactive protein for risk

prediction of post-operative delirium and post-operative neurocognitive disorder. Acta Anaesthesiol Scand.

;63(10):1282–1289. DOI: http://dx.doi.org/10.1111/aas.13441

Chen Y, Qin J. Modified Frailty Index Independently Predicts Postoperative Delirium and Delayed Neurocognitive Recovery After Elective Total Joint Arthroplasty. J Arthroplasty. 2021;36(2):449–453.

DOI: http://dx.doi.org/10.1016/j.arth.2020.07.074

Zhang Y, Duan B, Wang L, Ye Z, Pan Y, Guo Q, et al. Association between the variability of cerebral oxygen

saturation during cardiopulmonary bypass and delayed postoperative neurocognitive recovery in cardiac

valve surgical patients: A pilot study. Int J Clin Pract. 2021;75(1):e13651.

DOI: http://dx.doi.org/10.1111/ijcp.13651

Bukauskienė R, Širvinskas E, Lenkutis T, Benetis R, Steponavičiūtė R. Risk Factors for Delayed Neurocognitive

Recovery According to Brain Biomarkers and Cerebral Blood Flow Velocity. Med Kaunas Lith. 2020;56(6).

DOI: http://dx.doi.org/10.3390/medicina56060288

Evered LA, Vitug S, Scott DA, Silbert B. Preoperative frailty predicts postoperative neurocognitive disorders

after total hip joint replacement surgery. Anesth Analg. 2020;1582–1588.

DOI: http://dx.doi.org/10.1213/ANE.0000000000004893

Tasbihgou SR, Dijkstra S, Atmosoerodjo SD, Tigchelaar I, Huet R, Mariani MA, et al. A prospective pilot study

assessing levels of preoperative physical activity and postoperative neurocognitive disorder among patients undergoing elective coronary artery bypass graft surgery. PloS One. 2020;15(10):e0240128.

DOI: http://dx.doi.org/10.1371/journal.pone.0240128

Du J, Plas M, Absalom AR, van Leeuwen BL, de Bock GH. The association of preoperative anxiety and depression with neurocognitive disorder following oncological surgery. J Surg Oncol. 2020;121(4):676–687.

DOI: http://dx.doi.org/10.1002/jso.25836

Hu J, Li C-J, Wang B-J, Li X-Y, Mu D-L, Wang D-X. The sensitivity and specificity of statistical rules for

diagnosing delayed neurocognitive recovery with Montreal cognitive assessment in elderly surgical patients: A cohort study. Medicine (Baltimore). 2020 Jul 17;99(29):e21193.

DOI: http://dx.doi.org/10.1097/MD.0000000000021193

Boone MD, Sites B, von Recklinghausen FM, Mueller A, Taenzer AH, Shaefi S. Economic Burden of Postoperative Neurocognitive Disorders Among US Medicare Patients. JAMA Netw Open. 2020;3(7):e208931.

DOI: http://dx.doi.org/10.1001/jamanetworkopen.2020.8931

Jiang Z, Zhang X, Lv Y, Zheng X, Zhang H, Zhang X, et al. Preoperative Altered Spontaneous Brain Activity

and Functional Connectivity Were Independent Risk Factors for Delayed Neurocognitive Recovery in

Older Adults Undergoing Noncardiac Surgery. Neural Plast. 2020;2020:9796419.

DOI: http://dx.doi.org/10.1155/2020/9796419

Moller J, Cluitmans P, Rasmussen L, Houx P, Rasmussen H, Canet J, et al. Long-term postoperative cognitive

dysfunction in the elderly: ISPOCD1 study. The Lancet. 1998;351(9106):857–861.

DOI: http://dx.doi.org/10.1016/s0140-6736(97)07382-0

Dhakal A, Bobrin BD. Cognitive Deficits. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing;

[citado 12 de febrero de 2022]. Disponible en: http://www.ncbi.nlm.nih.gov/books/NBK559052/

Cole DJ, Kharasch ED. Postoperative Brain Function: Toward a Better Understanding and the American

Society of Anesthesiologists Perioperative Brain Health Initiative. Anesthesiology. 2018;129(5):861–863.

DOI: http://dx.doi.org/10.1097/ALN.0000000000002085

Hogan KJ. Nomenclature for Perioperative Cognitive Disorders: Comment. Anesthesiology. 2019;131(2):444–

DOI: http://dx.doi.org/10.1097/ALN.0000000000002832

Williamson PR, Altman DG, Bagley H, Barnes KL, Blazeby JM, Brookes ST, et al. The COMET Handbook:

version 1.0. Trials. 2017;18(S3):280. DOI: http://dx.doi.org/10.1186/s13063-017-1978-4

Pitman A, Underwood R, Hamilton A, Tyrer P, Yang M. Enhanced peer-review for optimising publication of

biomedical papers submitted from low- and middle-income countries: feasibility study for a randomised

controlled trial. BJPsych Open. 2019 Mar;5(2):e20. DOI: http://dx.doi.org/10.1192/bjo.2018.89

Artículos más leídos del mismo autor/a