Recommendations for the Nomenclature of Cognitive Change Associated With Anaesthesia and Surgery-2018

Nomenclature Consensus Working Group

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Cognitive change affecting patients after anaesthesia and surgery has been recognised for more than 100 yr. Research into cognitive change after anaesthesia and surgery accelerated in the 1980s when multiple studies utilised detailed neuropsychological testing for assessment of cognitive change after cardiac surgery. This body of work consistently documented decline in cognitive function in elderly patients after anaesthesia and surgery, and cognitive changes have been identified up to 7.5 yr afterwards. Importantly, other studies have identified that the incidence of cognitive change is similar after non-cardiac surgery. Other than the inclusion of non-surgical control groups to calculate postoperative cognitive dysfunction, research into these cognitive changes in the perioperative period has been undertaken in isolation from cognitive studies in the general population. The aim of this work is to develop similar terminology to that used in cognitive classifications of the general population for use in investigations of cognitive changes after anaesthesia and surgery. A multispecialty working group followed a modified Delphi procedure with no prespecified number of rounds comprised of three face-to-face meetings followed by online editing of draft versions.Two major classification guidelines [Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM-5) and National Institute for Aging and the Alzheimer Association (NIA-AA)] are used outside of anaesthesia and surgery, and may be useful for inclusion of biomarkers in research. For clinical purposes, it is recommended to use the DSM-5 nomenclature. The working group recommends that 'perioperative neurocognitive disorders' be used as an overarching term for cognitive impairment identified in the preoperative or postoperative period. This includes cognitive decline diagnosed before operation (described as neurocognitive disorder); any form of acute event (postoperative delirium) and cognitive decline diagnosed up to 30 days after the procedure (delayed neurocognitive recovery) and up to 12 months (postoperative neurocognitive disorder).

Original languageEnglish (US)
Pages (from-to)1189-1195
Number of pages7
JournalAnesthesia and Analgesia
Volume127
Issue number5
DOIs
StatePublished - Nov 1 2018

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Terminology
Anesthesia
Research
Preoperative Period
Perioperative Period
Delirium
Postoperative Period
Diagnostic and Statistical Manual of Mental Disorders
Cognition
Population
Thoracic Surgery
Biomarkers
Guidelines
Control Groups
Cognitive Dysfunction
Incidence
Neurocognitive Disorders

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Recommendations for the Nomenclature of Cognitive Change Associated With Anaesthesia and Surgery-2018. / Nomenclature Consensus Working Group.

In: Anesthesia and Analgesia, Vol. 127, No. 5, 01.11.2018, p. 1189-1195.

Research output: Contribution to journalArticle

Nomenclature Consensus Working Group. / Recommendations for the Nomenclature of Cognitive Change Associated With Anaesthesia and Surgery-2018. In: Anesthesia and Analgesia. 2018 ; Vol. 127, No. 5. pp. 1189-1195.
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