Journal of clinical anesthesiaJournal Article
07 May 2025
To investigate whether preoperative cognitive impairment is associated with postoperative outcomes under general anesthesia.
This population-based cohort study utilized a nationwide database in South Korea. We included patients who underwent surgery under general anesthesia at the hospital between January 1, 2021, and December 31, 2021. The Korean Dementia Screening Questionnaire-Cognition (KDSQ-C), a tool designed for efficient dementia screening, was used to evaluate preoperative cognitive impairment. The KDSQ-C is administered during biennial National Health Insurance Service medical evaluations beginning at age 66 years.
This study included 108,158 older patients who underwent surgery under general anesthesia. In a multivariable Cox regression model, patients with KDSQ-C ≥ 6 had a 35 % higher risk of 90-day mortality than those with KDSQ-C of 0-5 (hazard ratio [HR]: 1.35, 95 % confidence interval [CI]: 1.15, 1.57; P < 0.001). Increased 90-day mortality was observed in the following KDSQ-C groups compared to those with a score of 0-5: KDSQ-C 11-15 (HR: 1.54, 95 % CI: 1.13, 2.11; P = 0.007), KDSQ-C 16-20 (HR: 1.98, 95 % CI: 1.31, 2.99; P = 0.001), KDSQ-C 21-25 (HR: 1.99, 95 % CI: 1.29, 2.57; P = 0.004), and KDSQ-C 26-30 (HR: 2.03, 95 % CI: 1.26, 3.28; P = 0.004). Similar results were found in the analyses of one-year all-cause mortality and postoperative complications.
Older patients with preoperative cognitive impairment undergoing general anesthesia have higher mortality and morbidity rates, particularly in patients with KDSQ-C scores ≥11.
Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Share: