Empfehlungen zur Erfassung und Beschreibung perioperativer kognitiver Störungen in Wissenschaft und Praxis

Zusammenfassung

Perioperative kognitive Störungen treten bei über 70-jährigen Patienten häufig auf und führen zu einer reduzierten Lebensqualität. Dieser Beitrag stellt die 2018 publizierten Nomenklaturempfehlungen der Nomenclature Consensus Working Group vor, durch die perioperative kognitive Störungen erstmals exakt erfasst und beschrieben werden können. Dies ermöglicht ein gezieltes Screening und das frühzeitige Erkennen betroffener Patienten.

Abstract

Perioperative neurocognitive disorders (pNCD) are relevant to long term treatment outcome after elective surgery. The detection of pNCD is challenging and based on extended neuropsychological testing that often is not feasible due to economy driven time constraints during preoperative risk assessment. Only recently new recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery facilitated the transition of the former research diagnosis postoperative cognitive dysfunction (POCD) as a clinical diagnosis based on DSM-5 criteria. In our article we provide an overview of the new recommended diagnostic criteria for pNCD based on the publication by the Nomenclature Consensus Working Group in November 2018. We discuss ideas for the implementation of clinical routine pNCD screening in patients aged 70 years or older with elective surgery and possible options for further support of patients screened positively and their families and care givers.

Schlüsselwörter

perioperative (neuro-)kognitive Störungen (pNCD) - postoperatve kognitive Dysfunktion (POCD) - postoperatives Delir (POD) - präoperative Risikoevaluation - neuropsychologische Testung

Key words

perioperative neurocognitive disorders (pNCD) - postoperative cognitive dysfunction (POCD) - postoperative delirium (POD) - preoperative risk assessment - neuropsychological testing

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