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Postoperative cognitive dysfunction
Rundshagen I.. Deutsches Arzteblatt international, 2014-02-01
Topic: Risk, prevention and care in population studies
Background Older patients in particular are vulnerable to memory disturbances and other types of cognitive impairment after surgical operations. In one study, roughly 12% of patients over age 60 had postoperative cognitive dysfunction (POCD) three months after surgery. This is an important issue in perioperative care as extensive surgery on older patients becomes more common. Method Selective review of the literature. Results POCD is usually transient. It is diagnosed by comparing pre- and postoperative findings on psychometric tests. Its pathogenesis is multifactorial, with the immune response to surgery probably acting as a trigger. Factors that elevate the risk of POCD include old age, pre-existing cerebral, cardiac, and vascular disease, alcohol abuse, low educational level, and intra- and postoperative complications. The findings of multiple randomized controlled trials indicate that the method of anesthesia does not play a causal role for prolonged cognitive impairment. POCD is associated with poorer recovery and increased utilization of social financial assistance. It is also associated with higher mortality (hazard ratio 1.63, 95% confidence interval 1.11-2.38). Persistent POCD enters into the differential diagnosis of dementia. Conclusion POCD can markedly impair postoperative recovery. The findings of pertinent studies performed to date are difficult to generalize because of heterogeneous patient groups and different measuring techniques and study designs. Further investigation is needed to determine which test instruments are best for clinical use and which preventive strategies might lessen the incidence of POCD.
Key findings
- The findings of multiple randomized controlled trials indicate that the method of anesthesia does not play a causal role for prolonged cognitive impairment.
- POCD is associated with poorer recovery and increased utilization of social financial assistance.
- It is also associated with higher mortality (hazard ratio 1.63, 95% confidence interval 1.11-2.38).
Why it matters
This review reports that postoperative cognitive dysfunction is usually transient, and that multiple randomized controlled trials found the method of anesthesia does not play a causal role in prolonged cognitive impairment. It notes that persistent postoperative cognitive dysfunction enters into the differential diagnosis of dementia and is associated with higher mortality, but it reports no treatment or prevention for Alzheimer's disease.
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Study details
- Evidence strengthHigh
How this study scored 46/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on institution's track record, so that was left out: it earned 45 of the 97 points we could judge it on, which is 46 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Deutsches Arzteblatt international) |
| Journal's citation record | 1 / 4 | Deutsches Ärzteblatt international: journal h-index 139 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2014 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 359 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 25.6 citations a year over 14 year(s) since 2014 |
| Impact for its field and year | 4 / 6 | Cited 14.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 2 other studies in this library |
| Still being cited | 3 / 4 | Cited 69 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author I. Rundshagen: h-index 15 (OpenAlex, whole career) |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 0 institution(s) in 0 countries — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 24622758) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 45 / 97 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 45 of the 97 points we could judge it on is 46 out of 100. |
| Total | 46 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Rundshagen, I. (2014). Postoperative cognitive dysfunction. Deutsches Arzteblatt international. https://doi.org/10.3238/arztebl.2014.0119
Vancouver
Rundshagen I. Postoperative cognitive dysfunction. Deutsches Arzteblatt international. 2014. doi:10.3238/arztebl.2014.0119. PMID: 24622758.
BibTeX
@article{rundshagen2014-24622758,
author = {Rundshagen, I.},
title = {{Postoperative cognitive dysfunction}},
journal = {Deutsches Arzteblatt international},
year = {2014},
doi = {10.3238/arztebl.2014.0119},
pmid = {24622758},
url = {https://doi.org/10.3238/arztebl.2014.0119}
}
Later studies that cite this one
2 studies in the alzhub library list this one in their references.