Anaesthetic strategies in percutaneous aortic valve implantation: insights from a retrospective cohort study at a leading private hospital in a thriving metropolis of a developing nation
Bibliographic record
Abstract
Introduction: Postoperative cognitive dysfunction (POCD) is a decline of one or more neurocognitive abilities that develops after surgery; it is associated with increased morbidity and mortality.Cardiac surgery poses a greater risk of POCD because of the degree of surgical trauma and neuroinflammation precipitated by cardiopulmonary bypass (CPB).1e3 Previous studies have shown an incidence of 30e70%, with older patients at greater risk.This study aimed to reveal the incidence, and patient and surgical associated risks, of early POCD in older patients undergoing cardiac surgery at a tertiary care centre in Thailand.Methods: A single-centre prospective cohort study in older patients who underwent cardiac surgery with CPB use at King Chulalongkorn Memorial Hospital.Participants aged from 65 yr were enrolled and screened using the mini-mental state examination (MMSE).The Montreal Cognitive Assessment test (MOCA) was performed on the day before surgery and on postoperative days 5 to 7. Other surgical and patient data were collected perioperatively.Patient and surgical risks were identified for secondary outcomes.Results: We included 109 patients in the analysis.The incidence of early POCD was 47.6%.Patients who developed POCD were older (mean age 74.02 [6.88]) than those who did not develop POCD (71.64 [5.12], P0.045).Pre-existing cerebrovascular disease (P0.013) and inability to walk 450 m in a 6-min walk test (P0.002)were significantly associated with POCD.Preoperative MOCA score and diabetes mellitus were not significantly associated with POCD.Conclusions: The incidence of early POCD was 47.6%, which was comparable to previous studies.Advanced age, preexisting cerebrovascular disease, and inability to complete 450 m in a 6-min walk test were significantly associated with POCD.These findings might be useful in the prediction, detection, and prevention of POCD in older patients undergoing cardiac surgery.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".