Background: The ever-increasing fraction of older adults who requires operative care, needs not just longer life, but an active and good quality of life. The postoperative cognitive dysfunction (POCD) is well known complication of surgery and anaesthesia in elderly patient. Enhance recovery protocol helps in minimizing the stress response and in effect the onset of POCD. In current study, we made an attempt to reduce the prevalence of postoperative cognitive dysfunction in elderly patients by implementing enhanced recovery protocol, and evaluated the association with quality of life.
Methods: The current study was observational, prospective study conducted on patients aged above 70 of years. Cognitive function was assessed with Trail making test (TMT), Stroop color word test (SCWT) and Visual verbal learning test (VVLT), at preoperatively (T0) and postoperatively at 24 hours (T24), 96 hours (T96) and 3 months (T3). Quality of life was assessed in patients using WHO quality of life BREF Questionnaire, which was done at T0 and T3.
Results: Total forty-five patients were enrolled in the study, out of which 25 (55.5%) patients developed postoperative cognitive dysfunction (POCD) at T24 and T 96, while at T3, 14 (31.1%) had POCD. Major surgery was significantly associated with onset of POCD. Patients who developed POCD had significantly low quality of life, especially psychological component.
Conclusions; The incidence of POCD was 31.1% at 3 months after using Enhanced recovery protocol, so it should be made mandatory especially for elderly patients as POCD leads to worsening in the quality of life.
Key words: Postoperative cognitive dysfunction (POCD); Visual verbal learning test (VVLT); Trail making test (TMT); Stroop colour word test (SCWT)