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    ΕΠΙΛΕΓΜΕΝΕΣ ΔΉΜΟΣΙΕΥΣΕΙΣ
       Δ6
         THE EFFECT OF TYPE 2 DIABETES MELLITUS ON PERIOPERATIVE NEUROCOGNITIVE DISORDERS IN PATIENTS UNDERGOING ELECTIVE NON-CARDIAC SURGERY UNDER GENERAL ANESTHESIA. A PROSPECTIVE CASE-CONTROL STUDY
Dr Maria P Ntalouka1,2, Professor Elenis Arnaoutoglou1, Dr Spyridon Vrakas3, Associate Professor Chryssoula Staikou4, Mr Fragkiskos Angelis5, Professor Georgios Papadopoulos2, Associate Professor Petros Tzimas2
1 Department of Anesthesiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece,
2 Department of Anesthesiology and Postoperative Intensive Care, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece,
3 Department of Gastroenterology, Tzaneio Hospital, Peiraeus, Greece,
4 Department of Anaesthesiology, Aretaieio Hospital, National and Kapodistrian University of Athens, , Athens, Greece,
5 Department of Orthopedics Surgery and Musculoskeletal Trauma, Medical School, University of Thessaly, Larissa, Greece
    Background and Aim: Preliminary evidence suggest a possible relationship between type 2 diabetes mellitus (T2DM) and perioperative neurocognitive disorders (NCD). We sought to investigate whether patients with T2DM, undergoing elective non-cardiac surgery under general anesthesia, are at increased risk of perioperative NCD.
Material and Methods: A prospective case control study was designed. One-hundred and forty-four patients with T2DM and 144 healthy controls were recruited. Controls were matched for sex, age, type of operation and educational background. Postoperative delirium (POD), delayed neurocognitive recovery and postoperative NCD were evaluated.
Results: Two hundred twenty-eight patients were analyzed. Compared to controls, patients with T2DM, were diagnosed with higher rates of NCD pre-operatively (n = 96 versus n = 26, p < 0.05) and higher POD up to 4 days postoperatively (n = 204 versus n =68, p < 0.05). Increased rates of delayed neurocognitive recovery and postoperative neurocognitive disorder were recorded in patients with T2DM up to 9 months postoperatively (n = 473 versus n = 192, p < 0.05). Insulin dependent patients had higher rates of postoperative delirium on the 2nd (n = =38 versus n = =24, p < 0.05) and 3rd day (n = =27 versus n = =16, p < 0.05) when compared to non-insulin dependent patients. Logistic multivariable analysis revealed that patients with T2DM are at increased risk for postoperative cognitive disorders.
Conclusion: Patients with type 2 diabetes mellitus appear to be at a higher risk of perioperative neurocognitive disorders up to 9 months after elective non-cardiac surgery under general anesthesia.
Keywords: neurocognitive disorders; postoperative cognitive complications; diabetes mellitus, type 2; elective surgical procedures; anesthesia, general
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