Anesthesia, Covert Stroke
Conditions
Brief summary
With the development of population aging, the incidence of covert stroke gradually increased. Currently, there is still lack of prospective cohort study with large sample size on the relationship between perioperative covert stroke and postoperative cognitive outcomes. The investigators will perform a prospective cohort study. The aim of the study is to determine whether there is an association between perioperative covert stroke and postoperative cognitive outcomes in elderly patients undergoing noncardiac surgery.
Interventions
None listed
Sponsors
Chinese PLA General Hospital
Beijing Tiantan Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Eligible patients were aged ≥60 years and scheduled for elective non-cardiac surgery with general anesthesia, with or without concomitant regional analgesia. They were expected to have surgery lasting at least 2 hours of anesthesia and to stay in the hospital at least 2 days thereafter.
Exclusion criteria
* Patients have MRI contraindications, cannot complete the cognitive evaluation, undergo carotid artery surgery or refuse to sign informed consent will be excluded from the trial.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The incidence of perioperative stroke | Postoperative 1-7 days | Stroke is diagnosed by MRI |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative delirium | twice a day (from 8:00 to 10:00 and from 18:00 to 20:00) during the first postoperative 5 days | The Confusion Assessment Method for the Intensive Care Unit scale (CAM-ICU) or 3 min diagnostic interview for CAM (3D-CAM) will be applied to assess delirium. |
| Recovery quality | 1 day before surgery; and 7 days, 30 days, 3 months after surgery | The Modified Rankin Scale (mRS) and Lawton instrumental activities of daily living scale (IADL) will be applied to assess the recovery quality. |
| Postoperative cognitive function | 1 day before surgery; and 7 days, 3 months, 1 year after surgery | Cognitive assessment will be conducted by trained research members who are blinded to the clinical diagnosis, treatment and MRI. The Mini-mental State Examination, Montreal cognitive assessment-basic, Mini-Mental State Examination telephone scales, Montreal Cognitive Assessment telephone scales, and Telephone Interview of Cognitive Status scale will be used to assess the cognitive function. Postoperative cognitive dysfunction is defined as at least 2 standard deviation reduction on the Mini-Mental State Examination telephone scales or Montreal Cognitive Assessment telephone scales or a Telephone Interview of Cognitive Status scale scores≤27. |
| Depression state | 1 day before surgery; and 7 days, 30 days, 3 months after surgery | Depression state will be assessed with the Geriatric Depression Scale, Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9. |
| The incidence of comorbidity. | 30 days and 3 months after surgery | The incidence of myocardial infarction, cardiac arrest, pulmonary embolism, sepsis, surgical site infection and persistent postoperative pain. |
| The quality of life | 1 day before surgery; and 7 days, 30 days, 3 months after surgery | The quality of life will be assessed with the EuroQol-5D (EQ-5D) scale. |
Countries
China
Outcome results
None listed