Zhang et al identified risk factors for early Postoperative Cognitive Dysfunction (POCD) in older adults undergoing colorectal surgery. These can help to identify a patient who may require more aggressive management. The authors are from Nanjing First Hospital in China.

Patient selection: adult after colorectal surgery for colon cancer, age >= 65 years


Exclusions: postoperative delirium, drugs causing cognitive impairment, neurological or psychiatric disorders


Outcome: deterioration in cognition, as measured on day 7 after surgery


Cognitive testing: MMSE, VVLT (visual verbal learning test), DST1 (digital span test), DST2 (digital symbol test)


Risk factors for POCD:

(1) diabetes mellitus (odds ratio 8.4)

(2) fasting for >= 3 days after surgery (odds ratio 5.2)

(3) SIRS score 3 or 4 on the second day after surgery (range 0 to 4; odds ratio 7.0)

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