Disfunción cognitiva postoperatoria

Changes in mental function after operation occurs in patients of all ages. POCD (postoperative cognitive dysfunction) is defined as a postoperative memory or thinking impairment that has been corroborated by neuropsychological postoperative testing and is increasingly recognized as an important complication. The incidence of POCD varies depending on surgical procedure and age. POCD may be as high as 20-90% in aged patients and occurs most often in patients undergoing cardiovascular surgery. The etiology is multifactorial and is a result of a complex interaction between surgery and anesthesia. It has been associated with increased morbidity and mortality, risk of leaving the job and dependency. An assessment of cognitive function should be completed as a routine in older patients before and after surgery. The aim of this paper is to describe the incidence, risk factors, pathophysiology, treatment, preventive measures and long term consequences of cognitive dysfunction after surgery.