2018 Volume 22 Issue 1 Pages 49-54
Objective: We examined early postoperative cognitive dysfunction (POCD) in abdominal aortic aneurysm (AAA) surgery.
Methods: Data were collected on 96 AAA patients. POCD was compared between endovascular aneurysm repair (EVAR) and open aneurysm repair (OAR). Four cognitive tests were performed preoperatively and 1 week after surgery. POCD was defined as a decrease of at least 20% from baseline in performance on more than one test.
Results: The incidence of POCD was 9% in the EVAR group and 37% in the OAR group. Level of education, risk factors of arteriosclerosis and history of cerebrovascular disease were similar for both groups. The EVAR group was older than the OAR group (81±6 vs. 73±7 years) and had lower preoperative cognitive scores. On the other hand, the OAR group had longer procedures, higher rates of blood transfusion and needed more opioids and sevoflurane. Multivariate analysis revealed that the 5 factors most correlated with POCD were OAR, low preoperative cognitive score, age, amount of opioids and sevoflurane, and peripheral vascular disease.
Conclusions: EVAR reduced POCD, especially in elderly patients with mild cognitive impairment.
