No. Risk name Risk type Surgery type Sample size Definition Evaluation time Odds ratio P value
11Auxiliary inspectionClinical characteristicsCardiac Surgery448they demonstrated a decrease of＞0.5 standard deviations compared with preoperative values in 1 or more of the 3 domains.1week1.53(1.02-2.30)0.042
12Biochemical testClinical characteristicsCardiac Surgery448they demonstrated a decrease of＞0.5 standard deviations compared with preoperative values in 1 or more of the 3 domains.1week1.01(1.00-1.03)0.017
18Auxiliary inspectionClinical characteristicsEsophageal and gastrointestinal surgery41We used the Z score to identify POCD as recommended by ISPOCD,Post-operative cognitive dysfunction (POCD) is the deterioration of cognitive performance following anesthesia and surgery, presenting as impaired memory or concentration, or information processing 3-5day0.044
20Biochemical testClinical characteristicsElective joint arthroplasty (TJA)383delayed neurocognitive recovery was diagnosed while patients fulfilled the criteria of mild or major NCD based on DSM-V within 30 days postprocedure.1month2.01(1.19-3.23)0.021
42Biochemical testClinical characteristicsElective joint arthroplasty (TJA)257a Z score＞1.96 at least 2 times was defined as manifesting POCD1week1.77(1.13-2.78)0.016
44Biochemical testClinical characteristicsCardiac Surgery101When Z≥1.96 is considered abnormal,if there are two or more scale test abnormalities or a total Z score≥1.96,the diagnosis of POCD has occurred3month1.334(1.152-1.545)＜0.05
45Auxiliary inspectionClinical characteristicsCardiac Surgery101When Z≥1.96 is considered abnormal,if there are two or more scale test abnormalities or a total Z score≥1.96,the diagnosis of POCD has occurredNA2.815(1.014-7.818)0.047
48Biochemical testClinical characteristicsCardiac Surgery125POCD was defined as a decrease in performance of 1 SD or greater between the postoperative and preoperative Z scores on at least 1 neuropsychological test.1week0.69
52Biochemical testClinical characteristicsCardiac Surgery30The results were scored according to the corresponding scoring guide to calculateboth a raw and scaled score for each cognitive domain and total score.3-5day0.03
60Biochemical testClinical characteristicsCardiac Surgery134McNair score(≥43)/MMSE(Score≤24)6month0.019
66Auxiliary inspectionClinical characteristicsCardiac Surgery181POCD was defined as a decrease of 2 points or more in a patient’s Mini-Mental State Examination score2week0.807(0.690-0.943)0.007
68Biochemical testClinical characteristicsEsophageal and gastrointestinal surgery124POCD was defined as a decline of at least 1.5 SD on two or more of neuropsychological tests1week1.88(1.18-2.99)＜0.05
69Biochemical testClinical characteristicsEsophageal and gastrointestinal surgery124POCD was defined as a decline of at least 1.5 SD on two or more of neuropsychological tests1week3.26(1.07-9.91)0.037
85Auxiliary inspectionClinical characteristicsCardiac Surgery321MMSE The maximum test score is 30 and a score less than 24 indicates cognitive impairment.1-3day-0.6(-1.2-0.06)0.03
86Auxiliary inspectionClinical characteristicsCardiac Surgery321MMSE The maximum test score is 30 and a score less than 24 indicates cognitive impairment.1-3day-0.4(-0.8-0.03)0.007
111Biochemical testClinical characteristicsHead and neck surgery102For statistical analysis,according to previous report,a decline of more than 10 % or 2 points in MMSE test was regarded as POCD.1-3day0.870.008
117Biochemical testClinical characteristicsCardiac Surgery1711-3day0.045
118Biochemical testClinical characteristicsCardiac Surgery1711-3day0.029
122Biochemical testClinical characteristicsCardiac Surgery543The neuropsychological portion of the study design followed the consensus statements on the assessment of central nervous system disorders after cardiac surgery1week2.3(1.7-2.9)0.03
126Biochemical testClinical characteristicsCardiac Surgery180The neuropsychologic portion of the study was designed in accordance with the consensus statements on the assessment of central nervous system disorders after cardiac surgery1week2.0(1.5-3.3)0.042
153Biochemical testClinical characteristicsCardiac Surgery201POCD was defined as the deterioration of 1 standard deviation in at least one of the postoperative tests compared with their corresponding baseline scores.3month2.666(1.258-5.653)0.011
157Auxiliary inspectionClinical characteristicsHepatobiliary surgery25A diagnosis of POCD was made when there were significant findings in two or more postoperative neurocognitive tests.1week0
159Auxiliary inspectionClinical characteristicsHepatobiliary surgery25A diagnosis of POCD was made when there were significant findings in two or more postoperative neurocognitive tests.1week0.007
163Biochemical testClinical characteristicspelvic surgery50there were significant findings (≥1.96) in postoperative neurocognitive tests or the total Z score≥1.96,then the patients were defined as POCD1week0.025
168Biochemical testClinical characteristicsEsophageal and gastrointestinal surgery222POCD was diagnosed when the MMSE score was lower than 1 standard deviation (SD) compared with the baseline score.1week5.548(1.128-26.221) 0.035
171Biochemical testClinical characteristicsEsophageal and gastrointestinal surgery222POCD was diagnosed when the MMSE score was lower than 1 standard deviation (SD) compared with the baseline score.1week3.261(1.020-10.419)0.046
175Auxiliary inspectionClinical characteristicsNon-cardiac surgery80the composite Z score＞1.96 or the sum of more than two Z scores＞1.96 in a single test)1week0.049
191Auxiliary inspectionClinical characteristicsCardiac Surgery31POCD has been defined as a decline of 1 SD in performance in at least one testdischarge2.21(1.09-4.47)0.03
228Biochemical testClinical characteristicsElective joint arthroplasty (TJA)64A decrease of 4 points or more between each test was defined as significant cognitive dysfunction development1-3day0.014
229Biochemical testClinical characteristicscraniocerebral surgery1000a composite score of 30 or less (2 SD below the population norm of 50 was considered evidence of neuropsychological impairment.3month2.30(1.28-4.15)0.03
280Biochemical testClinical characteristicsCardiac Surgery264POCD in each patient was defined as decreased postoperative function on 2 or more test results.1week0.7
281Biochemical testClinical characteristicsCardiac Surgery264POCD in each patient was defined as decreased postoperative function on 2 or more test results.1week0.5
283Biochemical testClinical characteristicsCardiac Surgery264POCD in each patient was defined as decreased postoperative function on 2 or more test results.1year0.59
284Biochemical testClinical characteristicsCardiac Surgery264POCD in each patient was defined as decreased postoperative function on 2 or more test results.1year0.44
332Biochemical testClinical characteristicsCardiac Surgery362A patient was diagnosed as POCD if Z scores of two or more tests were equal or greater than 1.963week1.19(1.03-1.89)0.041
333Biochemical testClinical characteristicsCardiac Surgery362A patient was diagnosed as POCD if Z scores of two or more tests were equal or greater than 1.963week1.26(1.12-3.16)0.024
334Biochemical testClinical characteristicsCardiac Surgery362A patient was diagnosed as POCD if Z scores of two or more tests were equal or greater than 1.963week2.52(1.28-4.31)＜0.001
342Biochemical testClinical characteristicsThoracic surgery215when the t-MoCA scoredecreased by＞1.96 points at 1 month postoperatively,the patient was considered to have delayed neurocognitive recovery.3-5day0.428(0.188-0.975)0.043
345Auxiliary inspectionClinical characteristicscraniocerebral surgery229Cognitive impairment was defined as a decrease of Cognitive Assessment Montreal (MoCA)’s score in atleast two cognitive domains or any MoCA’s score of less than 26 points at the time of studycompared with baseline level.9month0.029
389Auxiliary inspectionClinical characteristicsEsophageal and gastrointestinal surgery312DNR was defined as a Z score (at least two Z scores in each individual test or the composite Z score) at≥1.961month1.716(1.211-2.433)0.002
390Biochemical testClinical characteristicsEsophageal and gastrointestinal surgery312DNR was defined as a Z score (at least two Z scores in each individual test or the composite Z score) at≥1.961month1.976(1.099-3.552)0.023
391Biochemical testClinical characteristicsEsophageal and gastrointestinal surgery312DNR was defined as a Z score (at least two Z scores in each individual test or the composite Z score) at≥1.961month0.774(0.620-0.966)0.024
392Auxiliary inspectionClinical characteristicsEsophageal and gastrointestinal surgery312DNR was defined as a Z score (at least two Z scores in each individual test or the composite Z score) at≥1.961month0.768(0.706-0.835)＜0.001
393Biochemical testClinical characteristicsEsophageal and gastrointestinal surgery221When at least two individual Z scores or a combined Z score were≥1.96 POCD was diagnosed.1week2.44(1.52-3.68)0.013
405Biochemical testClinical characteristicsElective joint arthroplasty (TJA)287According tothe guidance of ISPOCD1 and ISPOCD2,a Z score for each test wascalculated. In this study,patients were defined as sufferingPOCD while Z scores 1.96 on at least 2 tests1week2.67(1.41-3.94)0.025
416Auxiliary inspectionClinical characteristicsEsophageal and gastrointestinal surgery80POCD was diagnosed when the Z score was greater than1.96 or the combined Z score was≥1.96.1week6.995(1.948-25.111)0.003
418Biochemical testClinical characteristicsCardiac Surgery71delayed postoperative neurocognitive recovery was defined aspatient in whom scores decreased by more than or equal to one standard deviation from preoperative levels on one or two cognitive assessment scales.1week0.14(0.03-0.61)0.008
422Biochemical testClinical characteristicsNon-cardiac surgery123A patient was defined as having POCD when two or moreZ scores in individual tests or the combined Z score were -1.96 or less.1week8.427(1.595-44.511)0.012
425Biochemical testClinical characteristicsNon-cardiac surgery123A patient was defined as having POCD when two or moreZ scores in individual tests or the combined Z score were -1.96 or less.1week12.986(2.815-58.897)0.001
426Auxiliary inspectionClinical characteristicsSpinal surgery63if the Z score≥1.96 SD POCD.1week1.203(1.029-1.406)0.02
427Biochemical testClinical characteristicsSpinal surgery63if the Z score≥1.96 SD POCD.1week1.045(1.007-1.083)0.018
433Biochemical testClinical characteristicsEsophageal and gastrointestinal surgery104MMSE＜271week1.336(1.023-1.792)＜0.05
434Biochemical testClinical characteristicsEsophageal and gastrointestinal surgery104MMSE＜271.783(1.341-2.790)＜0.05
436Biochemical testClinical characteristicsElective joint arthroplasty (TJA)76The evidence of cognitive decline was that both MMSEand MoCA score declined more than 1 standard deviation (SD) after surgery compared with preoperative score1week1.041(1.002-1.081)0.04
437Biochemical testClinical characteristicsElective joint arthroplasty (TJA)76The evidence of cognitive decline was that both MMSEand MoCA score declined more than 1 standard deviation (SD) after surgery compared with preoperative score1week1.204(1.087-1.332)0.001
443Auxiliary inspectionClinical characteristicsHepatobiliary surgery132POCD if their Z scores were≥1.01week1.07 1.03-1.13)0.038
458Auxiliary inspectionClinical characteristicsSpinal surgery427POCD was defined as a drop of threeor more points on the MMSE 1 week post-surgery1week2.88(1.40-6.42)0.006
462Biochemical testClinical characteristicsNon-cardiac surgery120POCD was definedas a Z score of≤−1.96 on at least 2 different tests1week1.56(1.2-2.02)0.001
465Biochemical testClinical characteristicsNon-cardiac surgery97Patients were defined as having POCD if they had a Z score greater than 1.96 on two or more tests.1week＜0.01
472Auxiliary inspectionClinical characteristicsCardiac Surgery28POCD wasdefined as an individual decrease in more than two tests of at least 1 standard deviation from the group baseline mean forthat test.2week2.9(1.07-7.82)0.036
477Biochemical testClinical characteristicsNon-cardiac surgery102POCD is longer persisting DNR (between 1 and 12 months postop-erative),postoperative cognitive decline was subdivided into mild (1to 2 standard deviations below controls) and major (≥2 standard deviations below controls) DNR or POCD.1month＜0.05
489Biochemical testClinical characteristicsElective joint arthroplasty (TJA)165DNR was defined as a score of MoCA＜261week1.16(1.09-1.23)＜0.001
490Biochemical testClinical characteristicsElective joint arthroplasty (TJA)165DNR was defined as a score of MoCA＜261week0.92(0.86-0.98)0.003
501Biochemical testClinical characteristicsHead and neck surgery67A decrease of one standard deviation (SD) in both evaluation scales after surgery was considered dNCR1week1.054(1.027-1.095)0.001
502Biochemical testClinical characteristicsHead and neck surgery67A decrease of one standard deviation (SD) in both evaluation scales after surgery was considered dNCR1week1.181(1.087-1.334)0.001
521Biochemical testClinical characteristicsElective joint arthroplasty (TJA)100we chose to define a significant decline in cognitive function as a decrease in MMSE score of 4 or more 1week0.021
522Biochemical testClinical characteristicsElective joint arthroplasty (TJA)100we chose to define a significant decline in cognitive function as a decrease in MMSE score of 4 or more 1week0.007
527Auxiliary inspectionClinical characteristicsNon-cardiac surgery164Overall postoperative NCD was defined as a≥25% decline in the performance scores compared with the baseline score,in at least 2 of the 5 tests. 3month0.3(0.1-0.9)0.041
535Auxiliary inspectionClinical characteristicsCardiac Surgery44has been defined as a decrease in cognitive performance respect to preoperative baseline levels and multiple cognitive domains could be affected(a score deterioration in the performance≥1.8 SD).1.9(1.2-3.4)＜0.001
539Auxiliary inspectionClinical characteristicsCardiac Surgery41if their total standardized change Z score was≤1.01week0.05
555Biochemical testClinical characteristicsNon-cardiac surgery68CAMCOG score1year0.003
556Biochemical testClinical characteristicsNon-cardiac surgery68CAMCOG score1year0.002
557Biochemical testClinical characteristicsCardiac Surgery124we considered a 20% reduction incognitive function to be clinically important.1week2.2(1.7-2.8)0.03
564Biochemical testClinical characteristicsCardiac Surgery124we considered a 20% reduction incognitive function to be clinically important. 6month2.0(1.4-2.6)0.04
579Biochemical testClinical characteristicsCardiac Surgery36Postoperative cognitive impairment was defined by a significant decrease.1year2.9(1.6-4.3)0.01
580Biochemical testClinical characteristicsCardiac Surgery36Postoperative cognitive impairment was defined by a significant decrease.1year2.3(1.3-4.5)0.05
588Biochemical testClinical characteristicsThoracic surgery100a significant decrement was defined as a postoperative test score less than the preoperative score minus the absolute value ofthe mean: 2SDs of the difference between the 2 test scores in the controls,in 1 postoperative neuropsychological score1month(0.018-0.101)0.0039
589Biochemical testClinical characteristicsThoracic surgery100a significant decrement was defined as a postoperative test score less than the preoperative score minus the absolute value ofthe mean: 2SDs of the difference between the 2 test scores in the controls,in 1 postoperative neuropsychological score1month(0.042- 0.135)0.0046
619Biochemical testClinical characteristicsNon-cardiac surgery175according to the ISPOCD 1 study definition Z score≤-1.96 on at least two of the tests.1week5.61(1.13-27.79)0.04
622Biochemical testClinical characteristicsElective joint arthroplasty (TJA)313POCD was defined as a decline of 1 SD or more in MMSE score 7 d postoperatively when compared with the preoperative score1week0.87(0.72-0.99)0.032
642Biochemical testClinical characteristicsCardiac Surgery57The Z scores of the individual tasks weresummed to generate a composite standardised changescore. Postoperative cognitive dysfunction was definedas a Z score＜ 2 in two or more individual tasks ora composite Z score of＜ 2. /Long-term POCD was defined as POCD at 15 months postoperatively3month -0.073(-0.115--0.030)0.001
646Biochemical testClinical characteristicsCardiac Surgery57The Z scores of the individual tasks weresummed to generate a composite standardised changescore. Postoperative cognitive dysfunction was definedas a Z score＜ 2 in two or more individual tasks ora composite Z score of＜ 2. /Long-term POCD was defined as POCD at 15 months postoperatively15month -0.002(-0.004-0)0.045
665Auxiliary inspectionClinical characteristicscraniocerebral surgery117Postoperative cognitive decline in patients with SAH andcontrol subjects was defined as one or more neuropsycho-logical scores with a deficit.1month0.0076
676Biochemical testClinical characteristicsCardiac Surgery26RAVLT decrease ＞22month0.04
677Biochemical testClinical characteristicsCardiac Surgery26RAVLT decrease ＞27month0.035
740Auxiliary inspectionClinical characteristicsCardiac Surgery284Patients with a score of less than 26 were considered to have cognitive impairment.3week1.325(1.173-1.477)0.002
741Biochemical testClinical characteristicsCardiac Surgery284Patients with a score of less than 26 were considered to have cognitive impairment.3week1.229(1.076-1.382)0.006
747Biochemical testClinical characteristicsNon-cardiac surgery415The full score of the MMSE scaleis 30. The test process required about 5-10 min. The occurrence of POCD was determined based on an MMSEscore≤266month0.933(0.897-0.970)＜0.001
752Biochemical testClinical characteristicsNon-cardiac surgery415The full score of the MMSE scaleis 30. The test process required about 5-10 min. The occurrence of POCD was determined based on an MMSEscore≤266month0.944(0.917-0.973)＜0.001
753Biochemical testClinical characteristicsNon-cardiac surgery1593a postoperative MMSE score＜27 points was considered cognitive dysfunction.3month1.16(1.13-1.18)0
756Biochemical testClinical characteristicsNon-cardiac surgery1593a postoperative MMSE score＜27 points was considered cognitive dysfunction.3month1.08(1.02-1.15)0.007
757Biochemical testClinical characteristicsNon-cardiac surgery1593a postoperative MMSE score＜27 points was considered cognitive dysfunction.3month1.09(1.04-1.14)0
781Biochemical testClinical characteristicsElective joint arthroplasty (TJA)105POCD was defined as a postoperative MOCAscore＜26severe POCD was definedas a MOCA score＜201-3day1.025(1.001-1.049)0.038
800Biochemical testClinical characteristicsCardiac Surgery265was diagnosed when any one of the symptoms occurs: (1)delirium; (2) language disorder; (3) persecuted delusion; (4)indifference; (5) memory disorder.3.966(1.340-11.735)0.0128
802Biochemical testClinical characteristicsCardiac Surgery265was diagnosed when any one of the symptoms occurs: (1)delirium; (2) language disorder; (3) persecuted delusion; (4)indifference; (5) memory disorder.3.358(1.184-9.522)0.0227
810Auxiliary inspectionClinical characteristicsCarotid artery stenting(CAS)/carotid endarterectomy(CEA)84POCD was defined as a Z score 2based on apre- and postoperative MMSE1-3day25.541(2.100-310.614)0.011
811Auxiliary inspectionClinical characteristicsCarotid artery stenting(CAS)/carotid endarterectomy(CEA)84POCD was defined as a Z score 2based on apre- and postoperative MMSE1-3day 0.438(0.217-0.881)0.021
828Auxiliary inspectionClinical characteristicsCardiac Surgery88at least two ofthe eight tests showa decreasedscore＞1.96 SD of the whole group at baseline.3week 1.284(1.117-1.687)0.012
834Biochemical testClinical characteristicsSpinal surgery81It was diagnosed as a decline of1 SD or more in MMSE score 7 d postoperatively when compared with the preoperative score1week1.076(0.01-1.129)0.04
835Biochemical testClinical characteristicsCardiac Surgery150The diagnostic criteria were two or more tests with a Z score＞1.96 or a composite Z score＞1.967-14day1.074(1.011-1.140)0.02
839Biochemical testClinical characteristicsEsophageal and gastrointestinal surgery369POCD was diagnosed when the MMSE score decreased by more than 3 pointscompared with the baseline score1week3.751(1.124-12.522)0.032
844Auxiliary inspectionClinical characteristicsNon-cardiac surgery74(ISPOCD1) definition :at least two of the neuropsychological testZ scores were＞1.96 or the composite Z score was＞1.96.7-14day0.40(0.18-0.92)0.031
858Biochemical testClinical characteristicsElective joint arthroplasty (TJA)374Considering the impact of education level on MMSE assessment,combined with the actual situationin China and previous studies,the thresholds for those who were illiterate or attended at most primary school ormiddle school were≤17,≤20,and≤24,respectively. Individuals with a score below the threshold valuewere considered as cognitively impaired.Preoperation1.373(1.035-1.820)0.028


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