Ljiljana Gvozdenović
Clinical Center of Vojvodina, Serbia
Title: Impact of alcohol abuse after major non-cardiac surgery and postoperative cognitive dysfunction
Biography
Biography: Ljiljana Gvozdenović
Abstract
Introduction: Patients who misuse alcohol may be at increased risk of surgical complications and poorer function following hip replacement. The goal of this study was to determine whether neuro-cognitive function is impaired after non-cardiac surgery during general anesthesia in older patients with a history of alcohol abuse. Methods: Prospective study included 220 patients, male and female, triaged into three groups, with ASA levels I-IV. Subjects 55 years of age and older, with self-reported alcohol abuse and age-, sex-, education-matched non-alcoholic controls were tested using a neurocognitive battery before and 2 weeks after elective surgery or a corresponding time interval without surgery. Verbal memory, visuo-spatial memory and executive functions were assessed. From the total number of participants involved in the study, 135(67.5%) patients belonged to ASA III. Among all patients, 168(84%) patients were chronic alcohol users. Results: Pearson’s χ2 test showed a statistically significant difference in regard to the use of alcohol (χ2=19.220, df =1, p=0.000, p<0.05). Significant three-way interactions (analysis of variance) for visual immediate recall, visual delayed recall, semantic fluency, phonemic fluency and the color-word stroop test implied that cognitive performance in the alcoholic group decreased after surgery. Conclusion: In the study by Mason SE, which involved 255 elderly patients that were post-operatively admitted to the intensive care unit following a major abdominal surgery, development of POCD was two times greater in urgent cases (~ 40% of cases), when compared to elective interventions. Our results complement the data given by the World Health Organization and results of similar studies.