| No. | Risk name | Risk type | Surgery type | Sample size | Definition | Evaluation time | Odds ratio | P value |
|---|---|---|---|---|---|---|---|---|
| 13 | Core temperature | Intraoperative factors | Cardiac Surgery | 448 | they demonstrated a decrease of＞0.5 standard deviations compared with preoperative values in 1 or more of the 3 domains. | 1week | 1.15(1.01-1.31) | 0.042 |
| 17 | Intraoperative blood loss | Intraoperative factors | Radical nephrectomy with IVC thrombectomy | 65 | Cognitive impairment was defined as a 20% reduction in at least 20% of the main seven variables. | 6month | 1.001(1.00-1.001) | 0.04 |
| 24 | Mechanical lung ventilation | Intraoperative factors | Cardiac Surgery | 65 | A 20% decrease in postoperative test scores incomparison with preoperative baseline on two or more testswas defined as “cognitive dysfunction” | 6month | 0.024 | |
| 27 | Mechanical lung ventilation | Intraoperative factors | Thoracic surgery | 128 | Postoperative cognitive dysfunction was diagnosed if postoperative MoCA decreased atleast 2 scores compared with preoperative baseline value | 1-3day | 0.931(0.880-0.986) | 0.014 |
| 50 | Core temperature | Intraoperative factors | Abdominal surgery | 70 | The clinical manifestations of POCD include mental disorders,personality changes,anxiety,and impaired memory. | 1week | 18.429(1.843-184.25) | 0.013 |
| 54 | Intraoperative flow dynamics | Intraoperative factors | Cardiac Surgery | 15 | Change in MMSE was defined as preoperative MMSE score minus postoperative MMSEscore (with a positive score representing performance decrement) | 3-5day | 0.02 | |
| 70 | Intraoperative cerebral perfusion | Intraoperative factors | Carotid artery stenting(CAS)/carotid endarterectomy(CEA) | 80 | cognitive decline if they had a negative change score from post to pre-operative testing | 1month | 2.864(1.048-7.824) | 0.04 |
| 96 | Intraoperative blood loss | Intraoperative factors | Non-cardiac surgery | 56 | mean postsurgical performance scores were more than 2 SDs below,The magnitude ofthis difference would be sufficient to confer a diagnosis of impaired cognitive function | 2week | 0.005 | |
| 130 | Oxygenation monitoring | Intraoperative factors | Cardiac Surgery | 185 | significant impairment was defined as a decline from preoperative testing of＞1SD on＞20% of test measures (at least 2 of 6) | 6month | 1.3(1.0-1.4 | 0.03 |
| 136 | Oxygenation monitoring | Intraoperative factors | Spinal surgery | 87 | POCD for a given patient was a Reliable Change Index score of＜-1.96 occurring on 2 tests,we used the Reliable Change Index(RCI) | 1week | 1.006(1.00-1.01) | 0.014 |
| 160 | Intraoperative transfusion | Intraoperative factors | Hepatobiliary surgery | 25 | A diagnosis of POCD was made when there were significant findings in two or more postoperative neurocognitive tests. | 1week | 0.012 | |
| 162 | Oxygenation monitoring | Intraoperative factors | Thoracic surgery | 50 | When the Z score is found to be more than 1.96 two or more times,the patients can be recognized with POCD | 1week | 1.536 | 0.021 |
| 169 | Intraoperative blood loss | Intraoperative factors | Esophageal and gastrointestinal surgery | 222 | POCD was diagnosed when the MMSE score was lower than 1 standard deviation (SD) compared with the baseline score. | 1week | 3.317(1.094-10.059) | 0.034 |
| 182 | Intraoperative cerebral perfusion | Intraoperative factors | Carotid artery stenting(CAS)/carotid endarterectomy(CEA) | 109 | one standard deviation on at least two measures of cognitive function | 6month | 0.011 | |
| 189 | Intraoperative cerebral perfusion | Intraoperative factors | Cardiac Surgery | 31 | POCD has been defined as a decline of 1 SD in performance in at least one test | discharge | 0.9(0.82-0.98) | 0.02 |
| 222 | Mechanical lung ventilation | Intraoperative factors | Cardiac Surgery | 127 | Cognitive decline was defined as a decrease of one standard deviation or more in performance of at least two neurocognitive tests | 1week | 3.33(1.22-9.10) | 0.019 |
| 266 | Intraoperative flow dynamics | Intraoperative factors | Cardiac Surgery | 127 | Z score≥1.96 | 1year | 0.019 | |
| 306 | Oxygenation monitoring | Intraoperative factors | Thoracic surgery | 76 | a decrease of MMSE＞2 points | 1-3day | 2.03(0.74-5.59) | ＜0.05 |
| 307 | Oxygenation monitoring | Intraoperative factors | Thoracic surgery | 76 | a decrease of MMSE＞2 points | 1-3day | 9.56(1.75-52.13) | ＜0.05 |
| 321 | Intraoperative cerebral perfusion | Intraoperative factors | Cardiac Surgery | 57 | Z score≥1.96 | 1month | 0.011 | |
| 322 | Intraoperative cerebral perfusion | Intraoperative factors | Cardiac Surgery | 57 | Z score≥1.96 | 1month | 0.004 | |
| 340 | Core temperature | Intraoperative factors | Thoracic surgery | 215 | when the t-MoCA scoredecreased by＞1.96 points at 1 month postoperatively,the patient was considered to have delayed neurocognitive recovery. | 1month | 5.688(1.693-19.109) | 0.005 |
| 376 | Intraoperative flow dynamics | Intraoperative factors | Head and neck surgery | 112 | POCD was diagnosed if two or more scale tests of Z score≥2 ora total Z score of≥2 existed in the same patient | 1week | 5.512(1.24-24.506) | 0.025 |
| 411 | Intraoperative ACT | Intraoperative factors | Cardiac Surgery | 300 | We defined the presence of POCD when the Z score＜-1.96 on≥2 tests or the combined Z score＜-1.96. | 1-3day | 3.82(1.48-9.96) | 0.006 |
| 417 | Oxygenation monitoring | Intraoperative factors | Cardiac Surgery | 71 | delayed 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. | 1week | 4.93(1.25-19.42) | 0.023 |
| 440 | Intraoperative cerebral perfusion | Intraoperative factors | Carotid artery stenting(CAS)/carotid endarterectomy(CEA) | 51 | Patients with MMSE＜24 were considered severely cognitive impaired. Scores of 24-28 indicated mild cognitive impairment and＞28 was considered relatively normal. | 1month | 0.0162 | |
| 444 | Intraoperative flow dynamics | Intraoperative factors | Hepatobiliary surgery | 132 | POCD if their Z scores were≥1.0 | 1week | 0.95(0.91-0.99) | 0.026 |
| 466 | Oxygenation monitoring | Intraoperative factors | Elective joint arthroplasty (TJA) | 78 | The magnitude of result was called Z score,and patients with at least two Z scores＞2 were assigned into POCD group. | 1week | ＜0.01 | |
| 468 | Oxygenation monitoring | Intraoperative factors | Elective joint arthroplasty (TJA) | 78 | The magnitude of result was called Z score,and patients with at least two Z scores＞2 were assigned into POCD group. | 1week | 0.835 | ＜0.05 |
| 486 | Oxygenation monitoring | Intraoperative factors | Cardiac Surgery | 60 | MMSE decrease 2 | 0.03 | ||
| 500 | Oxygenation monitoring | Intraoperative factors | Spinal surgery | 61 | A decline in test performance scores by 20% in any of the tests | 1-3day | 6.02(1.18-38.32) | 0.039 |
| 562 | Oxygenation monitoring | Intraoperative factors | Cardiac Surgery | 124 | we considered a 20% reduction incognitive function to be clinically important. | 6month | 3.2(2.5-3.9) | 0.04 |
| 563 | Oxygenation monitoring | Intraoperative factors | Cardiac Surgery | 124 | we considered a 20% reduction incognitive function to be clinically important. | 6month | 1.9(1.5-2.7) | 0.01 |
| 567 | Intraoperative cerebral perfusion | Intraoperative factors | Cardiac Surgery | 59 | Cognitive decline is often detected in early postoperative period with substantial recovery within 1-3 months | 10day | 14.5(3.9-51.8) | ＜0.001 |
| 569 | Oxygenation monitoring | Intraoperative factors | Elective joint arthroplasty (TJA) | 46 | POCD was definedas Z scores on at least two tests of 1.96 or greater. | 1week | 1.618 | 0.011 |
| 581 | Intraoperative flow dynamics | Intraoperative factors | Cardiac Surgery | 36 | Postoperative cognitive impairment was defined by a significant decrease. | 1year | 1.6(1.3-3.1) | 0.05 |
| 594 | Operatingroom temperature | Intraoperative factors | Cardiac Surgery | 102 | All analyses were performed using Z scores based on the mean and SD of the preoperative cognitive scores | 5year | ＜0.001 | |
| 598 | Intraoperative cerebral perfusion | Intraoperative factors | Cardiac Surgery | 813 | POCD was defined as follows: MMSE score＜17 (illiteracy),＜20 (primary school literacy) or＜24 (junior high school or above),and MoCA score＜26. | 1week | 3.012(1.660-5.463) | ＜0.05 |
| 623 | Intraoperative transfusion | Intraoperative factors | Elective joint arthroplasty (TJA) | 313 | POCD was defined as a decline of 1 SD or more in MMSE score 7 d postoperatively when compared with the preoperative score | 1week | 1.57(1.09-2.32) | 0.045 |
| 624 | Intraoperative flow dynamics | Intraoperative factors | Elective joint arthroplasty (TJA) | 87 | POCD is defined when the composite Z score is greater than 1.96, or when the Z score is greater than 1.96 for at least 2 subtests | 1week | 0.91(0.83-0.99) | 0.034 |
| 626 | Intraoperative cerebral perfusion | Intraoperative factors | Cardiac Surgery | 70 | We avoided using an absolute change as a definition of significant decline in cognitive function | 1week | ＜0.01 | |
| 627 | Intraoperative cerebral perfusion | Intraoperative factors | Cardiac Surgery | 70 | We avoided using an absolute change as a definition of significant decline in cognitive function | 2month | ＜0.02 | |
| 634 | Intraoperative flow dynamics | Intraoperative factors | Non-cardiac surgery | 74 | POCD is described as adecline of the intellectual functions and processes (both basic and higher executive skills)that develops after surgery | 1-3day | 66.1(1.8-2423.3) | 0.022 |
| 654 | Intraoperative cerebral perfusion | Intraoperative factors | craniocerebral surgery | 66 | The cognitive function as assessed by Hindi‑languagemodification of mini‑mental state examination (HMSE) score was evaluated preoperatively,24 h after surgery,and at discharge from hospital. A score of≤23 was indicative of cognitive dysfunction. | discharge | present in 40% cases | ＜0.05 |
| 658 | Intraoperative organ protection | Intraoperative factors | Cardiac Surgery | 1403 | Z scores＞1.96 on 2 individual tests or the combined Z score,POCD was assumed. | 1week | 0.56 | |
| 659 | Intraoperative organ protection | Intraoperative factors | Cardiac Surgery | 1403 | Z scores＞1.96 on 2 individual tests or the combined Z score,POCD was assumed. | 3month | 0.53 | |
| 670 | Core temperature | Intraoperative factors | Cardiac Surgery | 180 | defined as≥1 SD deterioration in two or more of 12 neurocognitive tests | 1week | 2.72(1.24-5.95) | 0.012 |
| 672 | Mechanical lung ventilation | Intraoperative factors | Cardiac Surgery | 180 | defined as≥1 SD deterioration in two or more of 12 neurocognitive tests | 3month | 1.001(1.00-1.002) | 0.035 |
| 681 | Oxygenation monitoring | Intraoperative factors | Cardiac Surgery | 125 | 6month | 0.04 | ||
| 682 | Oxygenation monitoring | Intraoperative factors | Cardiac Surgery | 125 | 6month | 0.02 | ||
| 688 | Intraoperative transfusion | Intraoperative factors | Hepatobiliary surgery | 80 | Z score was determined by the followingmethod: ([change score] individual-[mean change score])/(stan-dard deviation change scoretotal) | 1week | 0.018 | |
| 691 | Intraoperative flow dynamics | Intraoperative factors | Cardiac Surgery | 71 | A patient with a drop of one category inany domain of the RBANS was considered to have POCD. | 3month | 0.044 | |
| 701 | Core temperature | Intraoperative factors | Head and neck surgery | 82 | POCD was diagnosed if postoperative scoredecreased by at least 20% | 1-3day | 0.007 | |
| 702 | Core temperature | Intraoperative factors | Head and neck surgery | 82 | POCD was diagnosed if postoperative scoredecreased by at least 20% | 1-3day | 0.02 | |
| 710 | BIS | Intraoperative factors | Non-cardiac surgery | 921 | ISPOCD We defined POCD if 2 or more Z scores were 1.96 or greater.defined by calculating a Z score for the CFQ using the same approach. | 3month | 0.93(0.85-0.97) | ＜0.001 |
| 711 | BIS | Intraoperative factors | Non-cardiac surgery | 921 | ISPOCD We defined POCD if 2 or more Z scores were 1.96 or greater.defined by calculating a Z score for the CFQ using the same approach. | 3month | 0.03 1.11(1.01-1.96) | 0.04 |
| 712 | Mechanical lung ventilation | Intraoperative factors | Non-cardiac surgery | 921 | ISPOCD We defined POCD if 2 or more Z scores were 1.96 or greater.defined by calculating a Z score for the CFQ using the same approach. | 3month | 2.31(1.15-15.6) | 0.03 |
| 713 | Intraoperative blood protection | Intraoperative factors | Cardiac Surgery | 266 | if they realized a decrease of＞1.0 SD compared with preoperative values in one or more of the 4 domains | 3-5day | ＞0.05 | |
| 714 | Intraoperative blood protection | Intraoperative factors | Cardiac Surgery | 266 | if they realized a decrease of＞1.0 SD compared with preoperative values in one or more of the 4 domains | 3month | ＞0.05 | |
| 721 | Oxygenation monitoring | Intraoperative factors | Cardiac Surgery | 240 | Cognitive decline was defined asa decline of one standard deviation or more in performance on one or more of the neuropsychologic tests | 3month | 2.22(1.11-4.45) | 0.024 |
| 731 | Oxygenation monitoring | Intraoperative factors | Abdominal surgery | 572 | If the postoperative score decreased bymore than 2 points compared with the preoperative score,it wasregarded as a decrease in postoperative cognitive function | 1-3day | 2.03(1.19∼4.47) | 0.03 |
| 776 | Oxygenation monitoring | Intraoperative factors | Cardiac Surgery | 113 | MMSE≤27 | 1week | 0.374(0.059-1.895) | 0.029 |
| 809 | Intraoperative flow dynamics | Intraoperative factors | Spinal surgery | 45 | a negative composite Z score indicates a decreased overall performance from baseline relative to the mean of all patients | 1month | 0.02 | |
| 832 | Intraoperative blood loss | Intraoperative factors | Spinal surgery | 81 | It was diagnosed as a decline of1 SD or more in MMSE score 7 d postoperatively when compared with the preoperative score | 1week | 0.995(0.992-0.999) | 0.009 |
| 833 | Intraoperative transfusion | Intraoperative factors | Spinal surgery | 81 | It was diagnosed as a decline of1 SD or more in MMSE score 7 d postoperatively when compared with the preoperative score | 1week | 0.012(0.001-0.307) | 0.007 |
| 840 | Intraoperative blood loss | Intraoperative factors | Esophageal and gastrointestinal surgery | 369 | POCD was diagnosed when the MMSE score decreased by more than 3 pointscompared with the baseline score | 1week | 3.436(1.476-8.000) | 0.004 |
| 842 | Intraoperative flow dynamics | Intraoperative factors | Non-cardiac surgery | 74 | (ISPOCD1) definition :at least two of the neuropsychological testZ scores were＞1.96 or the composite Z score was＞1.96. | 7-14day | 3.11(1.30-7.45) | 0.011 |
| 848 | Intraoperative cerebral perfusion | Intraoperative factors | Cardiac Surgery | 101 | ACE-III＜88 | 7-14day | ＜0.01 |
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