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Patients aged at least 60 years who underwent a major operation were enrolled. The primary outcome was instrumental activities of daily living IADLs 3 months after discharge. Secondary outcomes were the length of stay LOS , hospital cost, and factors that affected functional decline 3 months after surgery. Two hundred eighty-nine patients with a mean age of 72 years were enrolled. The incidence of POCD at 1 week was POCD at 1 week leaded to increase healthcare utilization in a middle-income country.
POD during hospitalization was associated with a decline in function after surgery and increased health care utilization. Keywords: Functional impairment, Hospital costs, Intensive care units, Mortality, Older patients, Postoperative cognitive dysfunction, Readmission, Surgical patients. The number of older patients who undergo surgery has steadily increased due to the progressive aging of the population. Older people are vulnerable to perioperative complications.
One of them is perioperative neurocognitive disorder [ 1 ], which includes postoperative cognitive dysfunction POCD , a prolonged state of cognitive impairment that mainly affects higher-level cognitive skills and memory, and postoperative delirium POD , an acute state of confusion and inattention. POCD was first described in [ 8 ]. The pathophysiology of the condition has been proposed [ 9 β 12 ].
Neuroinflammation due to peripheral surgical trauma and volatile anesthetics is one of the most reported mechanisms. Furthermore, low intraoperative cerebral oxygenation and cerebral microemboli are other potential mechanistic etiologies.
