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Postoperative cognitive dysfunction incidence for regional and general anesthesia in a level four institution in Bucaramanga (Santander, Colombia) during 2017

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.creatorValencia-Guampe, Jhon Sebastián
dc.creatorContreras-Forero, Francisco Javier
dc.creatorOchoa, Miguel Enrique
dc.creatorPerez, Margarita
dc.creatorPinillos, Mauricio
dc.creatorCelis, Laura
dc.creatorDelgado-Pascuaza, Angi Yaquely
dc.date2020-11-26
dc.date.accessioned2022-03-03T21:02:41Z
dc.date.available2022-03-03T21:02:41Z
dc.identifierhttps://revistas.unab.edu.co/index.php/medunab/article/view/3711
dc.identifier10.29375/01237047.3711
dc.identifier.urihttp://test.repositoriodigital.com:8080/handle/123456789/16485
dc.descriptionIntroduction. Within 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.en-US
dc.descriptionIntroducción. En 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 factoresde 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.es-ES
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dc.publisherUNABes-ES
dc.relationhttps://revistas.unab.edu.co/index.php/medunab/article/view/3711/3351
dc.relationhttps://revistas.unab.edu.co/index.php/medunab/article/view/3711/3374
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dc.rightsDerechos de autor 2020 MedUNABes-ES
dc.rightshttps://creativecommons.org/licenses/by-nc/4.0es-ES
dc.sourceMedUNAB; Vol. 23 No. 3 (2020): december 2020 - march 2021: Depression, Urinary Tract Infections, Occupational Burnout; 450-463en-US
dc.sourceMedUNAB; Vol. 23 Núm. 3 (2020): diciembre 2020 - marzo 2021: Depresión, Infecciones Urinarias, Agotamiento Profesional; 450-463es-ES
dc.source2382-4603
dc.source0123-7047
dc.subjectPostoperative Cognitive Dysfunctionen-US
dc.subjectCognitive dysfunctionen-US
dc.subjectIncidenceen-US
dc.subjectIntravenous anesthesiaen-US
dc.subjectGeneral anesthesiaen-US
dc.subjectBalanced anesthesiaen-US
dc.subjectDéficit Cognitivo Postoperatorioes-ES
dc.subjectDisfunción cognitivaes-ES
dc.subjectIncidenciaes-ES
dc.subjectAnestesia intravenosaes-ES
dc.subjectAnestesia generales-ES
dc.subjectAnestesia balanceadaes-ES
dc.titlePostoperative cognitive dysfunction incidence for regional and general anesthesia in a level four institution in Bucaramanga (Santander, Colombia) during 2017en-US
dc.titleIncidencia del déficit cognitivo postoperatorio en anestesia regional y general en una institución de cuarto nivel en Bucaramanga (Santander, Colombia) en el año 2017es-ES
dc.typeinfo:eu-repo/semantics/article
dc.typeinfo:eu-repo/semantics/publishedVersion


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