Preoperative Cognitive Impairment as a Predictor of Postoperative Outcomes in Elderly Patients Undergoing Spinal Surgery for Degenerative Spinal Disease

• Main Authors: Hyung Cheol Kim, Seong Bae An, Hyeongseok Jeon, Tae Woo Kim, Jae Keun Oh, Dong Ah Shin, Seong Yi, Keung Nyun Kim, Phil Hyu Lee, Suk Yun Kang, Yoon Ha
• Format: Article
• Language: English
• Published: MDPI AG 2021-03-01
• Series: Journal of Clinical Medicine
• Subjects: cognitive status; degenerative spinal disease; geriatrics; MMSE
• Online Access: https://www.mdpi.com/2077-0383/10/7/1385

Cognitive status has been reported to affect the peri-operative and post-operative outcomes of certain surgical procedures. This prospective study investigated the effect of preoperative cognitive impairment on the postoperative course of elderly patients (<i>n</i> = 122, >65 years), following spine surgery for degenerative spinal disease. Data on demographic characteristics, medical history, and blood analysis results were collected. Preoperative cognition was assessed using the mini-mental state examination, and patients were divided into three groups: normal cognition, mild cognitive impairment, and moderate-to-severe cognitive impairment. Discharge destinations (<i>p</i> = 0.014) and postoperative cardiopulmonary complications (<i>p</i> = 0.037) significantly differed based on the cognitive status. Operation time (<i>p</i> = 0.049), white blood cell count (<i>p</i> = 0.022), platelet count (<i>p</i> = 0.013), the mini-mental state examination score (<i>p</i> = 0.033), and the Beck Depression Inventory score (<i>p</i> = 0.041) were significantly associated with the length of hospital stay. Our investigation demonstrated that improved understanding of preoperative cognitive status may be helpful in surgical decision-making and postoperative care of elderly patients with degenerative spinal disease.