The structure and risk factors of the postoperative cerebral dysfunction in oncosurgery

Abstract

Aim of the research was to study the features of the structure of postoperative cerebral dysfunction, establishing the risk factors for the development of postoperative cerebral dysfunction and for the each of the clinical types during operations for malignant neoplasms of the chest and abdomen. The study was conducted in 2 stages: a retrospective study based on medical records and a prospective study. In a retrospective study by the method of directed selection from 93,129 clinical cases of patients, 47 cases of patients with acute stroke after surgery were selected. In prospective study, 102 patients (69 men, 33 women) aged 38 to 85 years were examined, the median age was 67 years. They were divided into two study groups: thoracic, abdominal. In a retrospective study, the incidence of perioperative stroke was 0.05%. In a prospective study of surgical operations for malignant neoplasms of the chest and abdomen, the incidence of postoperative cerebral dysfunction was 34%, perioperative stroke 2%, symptomatic delirium of the early postoperative period 11%, deferred cognitive impairment 31%. Statistical processing of the prospective study data revealed 10 risk factors for postoperative cerebral dysfunction, 12 risk factors for perioperative stroke, 7 risk factors for symptomatic delirium of the early postoperative period, and 6 risk factors for deferred cognitive impairment. For each of the clinical types of postoperative cerebral dysfunction the Charlson comorbidity index has a significant predictive value, and therefore it seems appropriate to include this parameter in the preoperative examination algorithm (3 tables, bibliography: 8 refs)