Postsurgery Subjective Cognitive and Short-Term Memory Impairment Among Middle-Aged Chinese Patients

Yang, L; Chen, W; Yang, D; Chen, D; Qu, Y; Hu, Y; Liu, D; He, J; Tang, Y; Zeng, H; Li, H; Zhang, Y; Ye, Z; Liu, J; Li, Q; Song, H

doi:10.1001/jamanetworkopen.2023.36985

Perioperative medicine & outcomes

Postsurgery Subjective Cognitive and Short-Term Memory Impairment Among Middle-Aged Chinese Patients

JAMA Netw OpenPublished 2 Oct 2023Prospective cohort study

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Authors' conclusion

This cohort study of middle-aged Chinese surgery patients found subjective cognitive and short-term memory impairment within 12 months after both cardiac and noncardiac surgery, with multiple identified risk factors

Study context

Population: Surgical patients aged 40 to 65 years, China Surgery and Anesthesia Cohort, 2 centers, July 2020–March 2023eligible and analysed
Participants: 10,149 patients

Exposure: Noncardiac surgery vs Cardiac surgery
Outcome: Subjective cognitive impairment (AD8 score ≥2) and short-term memory impairment (3-Word Recall Test score <3)
Follow-up: 1, 3, 6, and 12 months after surgery

Methodological detailsmulticentre (2 medical centers), generalized linear mixed models

Multicentre (2 medical centers)
Generalized linear mixed models

Main finding

As reported in the abstract

Incidence of AD8 and TRT abnormality after noncardiac surgery

And Dementia (AD8) abnormality, noncardiac, 7 days

2.2%

175 of 8105

AD8 abnormality, noncardiac, 6 months (then appeared to decrease)

17.1%

1059 of 6191

TRT abnormality, noncardiac, 7 days (U-shaped pattern)

38.9%

2040 of 5246

TRT abnormality, noncardiac, 12 months

49.0%

1394 of 2845

Observational data: associations, not effects.

Further findings

Outcome	← Lower odds with pittsburgh Sleep Quality Index ≥16 ←→ Higher odds with pittsburgh Sleep Quality Index ≥16 →	OR (95% CI)
Risk factors for aggressively deteriorative AD8 trajectory, noncardiacPittsburgh Sleep Quality Index ≥16 vs 0-5 · preoperative sleep disturbances	0.10.31310	4.04 (2.20–7.40)
Risk factors for AD8 abnormality, noncardiacPittsburgh Sleep Quality Index ≥16 vs 0-5 · preoperative sleep disturbances	0.10.31310	4.54 (2.40–8.59)
	0.10.31310Odds ratio (log scale)

Risk factors for aggressively deteriorative AD8 trajectory, noncardiac

	← Lower odds ←→ Higher odds →	OR (95% CI)
ICU stay ≥2 days	0.20.5125	2.43 (1.26–4.67)
Preoperative depressive symptoms	0.20.5125	1.76 (1.38–2.24)
	0.20.5125Odds ratio (log scale)

Risk factors for AD8 abnormality, noncardiac

	← Lower odds ←→ Higher odds →	OR (95% CI)
ICU stay ≥2 days	0.20.5125	3.07 (1.67–5.65)
Preoperative depressive symptoms	0.20.5125	2.23 (1.79–2.77)
	0.20.5125Odds ratio (log scale)

Risk factors for TRT abnormality and trajectory; cardiac surgery analyses

Fewer associated factors found

Original publication

Postsurgery Subjective Cognitive and Short-Term Memory Impairment Among Middle-Aged Chinese Patients. JAMA Netw Open. Published 2 October 2023. doi:10.1001/jamanetworkopen.2023.36985

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