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