Effects of an abnormal mini-mental state examination score on postoperative outcomes in geriatric surgical patients: a meta-analysis

BMC Anesthesiology

Tao Zhu¹  Shuang-jiao Cao¹  Dongxu- Chen¹  Lei Yang¹ 

[1]0000 0001 0807 1581, grid.13291.38, Department of Anesthesiology, West China Hospital, Sichuan University, 610041, Chengdu, People’s Republic of China

关键词: MMSE;    Geriatric;    Outcomes;    Postoperative delirium;    Mortality;    Meta-analysis;   

DOI  :  10.1186/s12871-019-0735-5

来源: publisher

【 摘 要 】

BackgroundPerioperative cognitive impairment (CI) following surgeries is prevalent in geriatric surgical population aged 60 and older. This meta-analysis was designed to investigate whether the Mini-Mental State Examination (MMSE) has prognostic value on adverse outcomes in aged surgical patients.MethodsPubMed, Cochrane, Embase and Medline through the Ovid were searched. Meta-analyses were carried out for CI versus non-cognitive impairment (NCI). Quality of evidence was assessed by the GRADE approach.ResultsOne randomized controlled trial, two retrospective cohort trials, and 18 prospective cohort trials were included in the meta-analysis. Perioperative diagnosis of CI by the MMSE had higher rates of patients suffering from postoperative delirium (POD) [odd ratio (OR) 5.02, 95% confidence interval (CI) 3.27, 7.71, P < 0.00001], in-hospital mortality (OR 7.51, 95% CI 2.17, 26.02, P = 0.001), mortality within 1 year (OR 2.53, 95% CI 1.95,3.29, P < 0.00001). Postoperative CI patients had no extended length of stay in orthopedic [standardized mean difference (SMD) -0.10, 95% CI -0.20, 0.17, P = 0.91)] nor rehabilitation wards ((SMD, 0.04; 95% CI, − 0.23 to 0.31; P = 0.78).ConclusionOlder patients with perioperative CI were more likely to suffer from POD and mortality. The MMSE showed certain value on risk stratification and prognosis evaluation in geriatric surgical population.Trial registrationPROSPERO CRD42018108739.

【 授权许可】

CC BY