Postoperative Cognitive Dysfunction Clinical Trial
Official title:
Whole Genome Single Nucleotide Polymorphisms in Elderly Patients With Postoperative Cognitive Dysfunction
Postoperative cognitive dysfunction (POCD) presents as a long-lasting decline in cognitive
function following surgery. Recognized as an important neuropsychological complication of
anesthesia and surgery, POCD occurs predominantly in elderly patients, and even after minor
procedures. It affects 41% of patients over the age of 60 years one week after major
noncardiac surgery, and persists until the third postoperative month in 13% of cases. POCD
has an adverse impact on quality of life, may result in prolonged hospitalization and
increased health care costs, and is associated with the risk of leaving the labor market
prematurely and dependency on social transfer payments, as well as increased one-year
mortality. Elderly patients are particularly at risk. Other risk factors include a
pre-existing cognitive impairment, cerebral, cardiac or vascular disease, diabetes, alcohol
consumption and a lower level of education. The occurrence of postoperative delirium seems to
predispose patients to POCD. However, POCD itself is not associated with the development of
dementia.
The pathogenic mechanism leading to POCD remains unclear. Numerous etiologic pathways have
been suggested: cerebral ischemia due to impaired intraoperative cerebral perfusion and/or
oxygenation, systemic inflammation and the effect of proinflammatory cytokines on the brain,
altered cholinergic neurotransmission, anesthetic neurotoxicity, hormonal changes induced by
surgical stress, sleep or circadian disturbances, or genetic factors.
Several studies have explored possible associations between a specific genotype and POCD;
however, these were predominantly performed in patients undergoing cardiac surgery or carotid
endarterectomy. Previous reports primarily focused on the analysis of the apolipoprotein E
genotype as a predisposing factor for POCD. Results of some of these studies have been pooled
in a recent meta-analysis. Other studies have investigated polymorphisms of the human
circadian clock gene HPER3, complement, cytochrome P450, platelet glycoprotein IIIa,
phosphodiesterase 4D, P-selectin, C-reactive protein, and the inducible nitric oxide synthase
promoter.
The primary aim of this retrospective study of available cohort data is to investigate a
specific genotype and to identify single nucleotide polymorphisms (SNPs) which may predispose
elderly patients undergoing major noncardiac surgery to POCD.
n/a
| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Recruiting |
NCT05990790 -
The Effect of Desflurane Versus Sevoflurane Versus Propofol on Postoperative Delirium
|
Phase 4 | |
| Terminated |
NCT03337282 -
Incidence and Characteristics of Postoperative Cognitive Dysfunction in Elderly Quebec Francophone Patients
|
||
| Active, not recruiting |
NCT02965235 -
Correlations of Epigenetic Changes With POCD in Surgical Patients
|
N/A | |
| Not yet recruiting |
NCT02224443 -
Effects of Different Doses of Dexmedetomidine on Postoperative Cognitive Dysfunction in Elderly Hypertensive Patients
|
Phase 4 | |
| Recruiting |
NCT01934049 -
Postoperative Recovery in Elderly Patients Undergoing Hip Hemi-arthroplasty
|
Phase 4 | |
| Terminated |
NCT00991328 -
Role of Absolute Cerebral Oximetry to Prevent Neurocognitive Injury in Elderly Patients Undergoing Cardiac Surgery
|
Phase 3 | |
| Terminated |
NCT00757913 -
n-3 Enriched Nutrition Therapy and Postoperative Cognitive Dysfunction After Cardiac Surgery
|
Phase 4 | |
| Terminated |
NCT00455143 -
Cognitive Protection - Dexmedetomidine and Cognitive Reserve
|
Phase 4 | |
| Recruiting |
NCT06176144 -
Impact of Desflurane and Sevoflurane on Postoperative Delirium in Elderly Patients
|
N/A | |
| Completed |
NCT03620968 -
Implementation of a Cognitive Training Program to Reduce the Risk of Postoperative Cognitive Dysfunction
|
N/A | |
| Completed |
NCT04701801 -
Correlation of Preoperative Anxiety With Early Postoperative Cognitive Dysfunction in Breast Cancer Patients
|
||
| Not yet recruiting |
NCT06469515 -
Older People's Neurocognitive Recovery After Cardiac Surgery
|
||
| Completed |
NCT02931877 -
Comparison of Postoperative Outcome After Sevoflurane and Propofol Anaesthesia
|
Phase 4 | |
| Not yet recruiting |
NCT02909413 -
Comparison of Desflurane With Sevoflurane for School-age Children in Postoperative Cognitive Function
|
N/A | |
| Completed |
NCT02650687 -
Optimizing Postoperative Cognition the Elderly
|
||
| Not yet recruiting |
NCT01622452 -
Post Cardiac Surgery Neurocognitive Decline: Correlations Between Neuropsychological Tests and Functional MRI Techniques
|
N/A | |
| Completed |
NCT01103752 -
Postoperative Cognitive Dysfunction After Total Knee or Hip Replacement Surgery in Fast-track Set-up
|
N/A | |
| Completed |
NCT04312516 -
Greek Validation of ACE III Test in Perioperative Patients
|
||
| Not yet recruiting |
NCT05668559 -
Transcranial Magnetic Stimulation and Perioperative Neurocognitive Disorders
|
N/A | |
| Not yet recruiting |
NCT05439707 -
Effects of Perioperative Transauricular Vagus Nerve Electrical Stimulation on POD, POCD and CPSP
|
N/A |