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.
Study Type
OBSERVATIONAL
Enrollment
934
Beijing TianTan Hospital
Beijing, China
Chinese People's Liberation Army General Hospital
Beijing, China
The incidence of perioperative stroke
Stroke is diagnosed by MRI
Time frame: Postoperative 1-7 days
Postoperative cognitive function
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.
Time frame: 1 day before surgery; and 7 days, 3 months, 1 year after surgery
Postoperative delirium
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.
Time frame: twice a day (from 8:00 to 10:00 and from 18:00 to 20:00) during the first postoperative 5 days
Recovery quality
The Modified Rankin Scale (mRS) and Lawton instrumental activities of daily living scale (IADL) will be applied to assess the recovery quality.
Time frame: 1 day before surgery; and 7 days, 30 days, 3 months after surgery
The quality of life
The quality of life will be assessed with the EuroQol-5D (EQ-5D) scale.
Time frame: 1 day before surgery; and 7 days, 30 days, 3 months after surgery
Depression state
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Depression state will be assessed with the Geriatric Depression Scale, Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9.
Time frame: 1 day before surgery; and 7 days, 30 days, 3 months after surgery
The incidence of comorbidity.
The incidence of myocardial infarction, cardiac arrest, pulmonary embolism, sepsis, surgical site infection and persistent postoperative pain.
Time frame: 30 days and 3 months after surgery