Peri-Operative Risk Factors Associated with Post-Operative Cognitive Dysfunction (POCD): An Umbrella Review of Meta-Analyses of Observational Studies

Nikolaj Travica*, Mojtaba Lotfaliany, Andrew Marriott, Seyed A Safavynia, Melissa M Lane, Laura Gray, Nicola Veronese, Michael Berk, David Skvarc, Hajara Aslam, Elizabeth Gamage, Melissa Formica, Katie Bishop, Wolfgang Marx

*Corresponding author for this work

Research output: Contribution to journalReview articleResearchpeer-review

8 Citations (Scopus)
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Abstract

This umbrella review aimed to systematically identify the peri-operative risk factors associated with post-operative cognitive dysfunction (POCD) using meta-analyses of observational studies. To date, no review has synthesised nor assessed the strength of the available evidence examining risk factors for POCD. Database searches from journal inception to December 2022 consisted of systematic reviews with meta-analyses that included observational studies examining pre-, intra- and post-operative risk factors for POCD. A total of 330 papers were initially screened. Eleven meta-analyses were included in this umbrella review, which consisted of 73 risk factors in a total population of 67,622 participants. Most pertained to pre-operative risk factors (74%) that were predominantly examined using prospective designs and in cardiac-related surgeries (71%). Overall, 31 of the 73 factors (42%) were associated with a higher risk of POCD. However, there was no convincing (class I) or highly suggestive (class II) evidence for associations between risk factors and POCD, and suggestive evidence (class III) was limited to two risk factors (pre-operative age and pre-operative diabetes). Given that the overall strength of the evidence is limited, further large-scale studies that examine risk factors across various surgery types are recommended.

Original languageEnglish
Article number1610
Pages (from-to)1-20
Number of pages20
JournalJournal of Clinical Medicine
Volume12
Issue number4
DOIs
Publication statusPublished - 17 Feb 2023
Externally publishedYes

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