Cognitive Impairment and Postoperative Outcomes in Patients Undergoing Primary Total Hip Arthroplasty and Primary Total Knee Arthroplasty: A Systematic Review and Meta-analysis.
Ravi S Jatti, Nikhil Manvi, Shubham Agarwal
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In 30 seconds
This systematic review and meta-analysis evaluated the impact of preoperative cognitive impairment on postoperative outcomes in older adults undergoing primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). Involving 10,573 patients, the study found that preoperative cognitive impairment significantly increased the risk of adverse outcomes, with an odds ratio of 2.38 (95% CI 1.78-2.98; P < 0.001).
Key findings
- Preoperative cognitive impairment was associated with postoperative delirium and cognitive dysfunction.
- The odds of adverse postoperative outcomes were more than doubled in patients with cognitive impairment (OR 2.38).
- Long-term cognitive decline and increased mortality were linked to preoperative cognitive impairment.
- Substantial heterogeneity was observed among the included studies (I² = 76.7%).
Why it matters
Understanding the relationship between cognitive impairment and surgical outcomes is crucial for optimizing preoperative assessments and improving patient care. Identifying high-risk patients can lead to tailored perioperative strategies that enhance recovery and reduce complications.