The association of preoperative anxiety and depression with neurocognitive disorder following oncological surgery.


Journal

Journal of surgical oncology
ISSN: 1096-9098
Titre abrégé: J Surg Oncol
Pays: United States
ID NLM: 0222643

Informations de publication

Date de publication:
Mar 2020
Historique:
received: 11 09 2019
accepted: 31 12 2019
pubmed: 14 1 2020
medline: 7 3 2020
entrez: 14 1 2020
Statut: ppublish

Résumé

The proposed underlying mechanisms of anxiety and depression, and of postoperative neurocognitive disorder (NCD), each include immune system involvement. Therefore, the aims of this study were to investigate the incidence of postoperative NCD 3 months after surgery among oncological patients undergoing surgery and to evaluate the role of preoperative anxiety and depression. A consecutive series of patients (age ≥ 18 years) undergoing surgery for the removal of solid tumors were included (n = 218). Cognitive performance was assessed preoperatively and at 3 months postoperatively. Preoperative anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale. NCD affected 12.3% of elderly patients (age ≥ 70 years, n = 57) at 3 months after surgery, with executive function mostly affected. By contrast, 8.4% of younger patients (age < 70 years, n = 107) were affected, with information processing speed mostly affected. Low educational attainment was a risk factor (OR, 6.0; 95% CI, 1.9-19.0) of overall NCD, whereas preoperative anxiety was associated with decline in the domain of executive function. Postoperative NCD is a complication of oncological surgery for all adults instead of the elderly only. Preoperative anxiety was associated with an increased risk of executive function decline, and low educational attainment was a key factor for overall NCD.

Sections du résumé

BACKGROUND BACKGROUND
The proposed underlying mechanisms of anxiety and depression, and of postoperative neurocognitive disorder (NCD), each include immune system involvement. Therefore, the aims of this study were to investigate the incidence of postoperative NCD 3 months after surgery among oncological patients undergoing surgery and to evaluate the role of preoperative anxiety and depression.
METHOD METHODS
A consecutive series of patients (age ≥ 18 years) undergoing surgery for the removal of solid tumors were included (n = 218). Cognitive performance was assessed preoperatively and at 3 months postoperatively. Preoperative anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale.
RESULTS RESULTS
NCD affected 12.3% of elderly patients (age ≥ 70 years, n = 57) at 3 months after surgery, with executive function mostly affected. By contrast, 8.4% of younger patients (age < 70 years, n = 107) were affected, with information processing speed mostly affected. Low educational attainment was a risk factor (OR, 6.0; 95% CI, 1.9-19.0) of overall NCD, whereas preoperative anxiety was associated with decline in the domain of executive function.
CONCLUSION CONCLUSIONS
Postoperative NCD is a complication of oncological surgery for all adults instead of the elderly only. Preoperative anxiety was associated with an increased risk of executive function decline, and low educational attainment was a key factor for overall NCD.

Identifiants

pubmed: 31930514
doi: 10.1002/jso.25836
pmc: PMC7064888
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

676-687

Commentaires et corrections

Type : CommentIn

Informations de copyright

© 2020 The Authors. Journal of Surgical Oncology published by Wiley Periodicals, Inc.

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Auteurs

Jing Du (J)

Department of Epidemiology, University of Groningen, University Medical Center Groningen, Hanzeplein, Groningen, The Netherlands.

Matthijs Plas (M)

Department of Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein, Groningen, The Netherlands.

Anthony R Absalom (AR)

Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Hanzeplein, Groningen, The Netherlands.

Barbara L van Leeuwen (BL)

Department of Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein, Groningen, The Netherlands.

Geertruida H de Bock (GH)

Department of Epidemiology, University of Groningen, University Medical Center Groningen, Hanzeplein, Groningen, The Netherlands.

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