No. Risk name Risk type Surgery type Sample size Definition Evaluation time Odds ratio P value
6Postoperative adjuvant therapyPostoperative factorsElective joint arthroplasty (TJA)104According to ISPOCD, POCD is defined as either, at least two in-dividual Z scores＞1.96 or a composite Z score＞1.96, andhence significant(p＜0.05) from the 95% confidence interval in theselected population. We selected a Z score≥1.96 in two tests as thecriterion to define POCD in the current study2-3day0.008
7Postoperative adjuvant therapyPostoperative factorsElective joint arthroplasty (TJA)104According to ISPOCD, POCD is defined as either, at least two in-dividual Z scores＞1.96 or a composite Z score＞1.96, andhence significant(p＜0.05) from the 95% confidence interval in theselected population. We selected a Z score≥1.96 in two tests as thecriterion to define POCD in the current study2-3week0.042
10Length Of StayPostoperative factorsCardiac Surgery448they demonstrated a decrease of＞0.5 standard deviations compared with preoperative values in 1 or more of the 3 domains.1week1.88(1.27-2.79)0.002
23Postoperative cerebrovascular diseasePostoperative factorsCardiac Surgery65A 20% decrease in postoperative test scores incomparison with preoperative baseline on two or more testswas defined as “cognitive dysfunction”2week0.035
51Postoperative painPostoperative factorsAbdominal surgery70The clinical manifestations of POCD include mental disorders,personality changes,anxiety,and impaired memory.1week2.249(1.207-4.191)0.011
53Length Of StayPostoperative factorsCardiac Surgery30The results were scored according to the corresponding scoring guide to calculateboth a raw and scaled score for each cognitive domain and total score.3-5day0.01
67Length Of StayPostoperative factorsCardiac Surgery181POCD was defined as a decrease of 2 points or more in a patient’s Mini-Mental State Examination score2week1.212(1.071-1.372)0.002
80Other postoperative complicationsPostoperative factorsCardiac Surgery939defining cognitive impairment of one standard deviation,6month0.001
88Postoperative cardiovascular diseasePostoperative factorsCardiac Surgery113Postoperative neurocognitive dysfunction was defined as the composite end point of a one standard deviation decrement from baseline on two or more psychometric tests or a new neurologic deficit.4-6week0.02(0.00-0.78)0.036
90Length Of StayPostoperative factorsCardiac Surgery113Postoperative neurocognitive dysfunction was defined as the composite end point of a one standard deviation decrement from baseline on two or more psychometric tests or a new neurologic deficit.4-6week1.51(1.17-1.95)0.001
95Length Of StayPostoperative factorsNon-cardiac surgery56mean postsurgical performance scores were more than 2 SDs below,The magnitude ofthis difference would be sufficient to confer a diagnosis of impaired cognitive function2week0.005
97Length Of StayPostoperative factorsNon-cardiac surgery56mean postsurgical performance scores were more than 2 SDs below,The magnitude ofthis difference would be sufficient to confer a diagnosis of impaired cognitive function2week0.05
100Length Of StayPostoperative factorsCardiac Surgery77Patients were defined as having cognitivedysfunction when their composite Z score was less than −1.96 (2 standard deviations)1week0.002
101Postoperative cognitive dysfunctionPostoperative factorsCardiac Surgery77Patients were defined as having cognitivedysfunction when their composite Z score was less than −1.96 (2 standard deviations)1week0.001
102Postoperative cognitive dysfunctionPostoperative factorsCardiac Surgery56postoperative cognitive dysfunction was defined as a patient’sZ scores from three different tests being below -1.96 (at least one test from each cognitive domain of recent verbal memory,recent nonverbal memory,and executive functions).1week13.7(1.4-133.8)＜0.05
108Postoperative cognitive dysfunctionPostoperative factorsCardiac Surgery1040The RBANS has a mean (standard deviation) population age-adjusted score of 100 ± 15 with lower scores indicating worse global cognitive function.1year0.003
110Postoperative cognitive dysfunctionPostoperative factorsCardiac Surgery83TFDD＜351week0.04
138Postoperative cerebrovascular diseasePostoperative factorsCardiac Surgery64A cognitive composite test score (defined as difference between the number of tests with improvement and decline)≤-2 in TA-TAVI patients and≤-3 in AVR patients denoted a clinically significant cognitive decline in the individual patient.discharge2.37(0.05-113.75) 0.66
165Postoperative painPostoperative factorsEsophageal and gastrointestinal surgery222POCD was diagnosed when the MMSE score was lower than 1 standard deviation (SD) compared with the baseline score.1-3day7.618(3.231-17.962)＜0.001
167Postoperative painPostoperative factorsEsophageal and gastrointestinal surgery222POCD was diagnosed when the MMSE score was lower than 1 standard deviation (SD) compared with the baseline score.1week13.823(4.779-39.981) ＜0.001
179Length Of StayPostoperative factorsCardiac Surgery227ISPOCD A patient was defined as having POCD when two Z scores in individual tests or the combined Z score were 1.96 or more.1week0.895(0.817-0.980)0.017
205Postoperative cognitive dysfunctionPostoperative factorsNon-cardiac surgery1064A patient was classified as exhibiting POCD if the Z scores on two individual tests or the combined Z score was 1.96 or greater.3month0.32(0.19-0.54)＜0.0001
207Postoperative cognitive dysfunctionPostoperative factorsCardiac Surgery107POCD was defined using the same definition that was used in the ISPOCD1 study.Z score≥1.96 or total z≥1.91week1.744(1.173-2.593)0.006
208Postoperative cognitive dysfunctionPostoperative factorsNon-cardiac surgery120POCD was diagnosed when Z score＞1.96 of more than 1 test.1week0.007
215Postoperative cognitive dysfunctionPostoperative factorsCardiac Surgery261Decline in postoperative function was defined as a drop of 1 SD or more in the scores on tests of any one of four domains of cognitive function. (A reduction of 1 SD represents a decline in function of approximately 20 percent.)discharge＜0.001
223Length Of StayPostoperative factorsCardiac Surgery127Cognitive decline was defined as a decrease of one standard deviation or more in performance of at least two neurocognitive tests1week3.83(1.3-11.29)0.015
242Postoperative cognitive dysfunctionPostoperative factorsCardiac Surgery100POCD was defined as a decrease of 2 SD population means on at least two in the test battery1week0.004
243Postoperative cognitive dysfunctionPostoperative factorsCardiac Surgery100POCD was defined as a decrease of 2 SD population means on at least two in the test battery1week0.036
244Postoperative cognitive dysfunctionPostoperative factorsCardiac Surgery100POCD was defined as a decrease of 2 SD population means on at least two in the test battery1week0.016
245Postoperative cognitive dysfunctionPostoperative factorsCardiac Surgery100POCD was defined as a decrease of 2 SD population means on at least two in the test battery3month0.005
246Postoperative cognitive dysfunctionPostoperative factorsCardiac Surgery100POCD was defined as a decrease of 2 SD population means on at least two in the test battery3month0.011
247Postoperative cognitive dysfunctionPostoperative factorsCardiac Surgery100POCD was defined as a decrease of 2 SD population means on at least two in the test battery3month0.045
248Postoperative cognitive dysfunctionPostoperative factorsCardiac Surgery100POCD was defined as a decrease of 2 SD population means on at least two in the test battery3month＜0.001
262Postoperative adjuvant therapyPostoperative factorsNon-cardiac surgery20scores＜mean-1 standard deviation in each age range (50s:＜23,60s:＜19,70s:＜16) as impaired.6month0.033
265Postoperative blood pressurePostoperative factorsCardiac Surgery127Z score≥1.961year0.011
267Length Of StayPostoperative factorsCardiac Surgery127Z score≥1.961year0.002
269Postoperative cerebrovascular diseasePostoperative factorscraniocerebral surgery152POCD was defined as a postoperative MOCA score＜266month6.153(1.587-23.855)0.009
291Postoperative cardiovascular diseasePostoperative factorsCardiac Surgery411“cognitive deficit” outcome event was defined as a decline in performance of 1 sd or more in any of the independent domains.6week＜0.036
294Postoperative cognitive dysfunctionPostoperative factorsCardiac Surgery289POCD was defined as a decrease in the Montreal Cognitive Assessment (MoCA) score (≥2) 1 week after surgery1week0.02
311Postoperative cognitive dysfunctionPostoperative factorsCardiac Surgery131A patient was defined as having POCD if the Z scores on an individual test or the combined Z score of multiple testswas≥21week1.082(1.073-1.092)＜0.001
319Postoperative cognitive function assessmentPostoperative factorsAbdominal surgery46MMSE1week0
328Postoperative cognitive dysfunctionPostoperative factorsNon-cardiac surgery89patients with index scores of 2 or greater were classified as showing some cognitiveimpairment3month0.009
329Postoperative cognitive function assessmentPostoperative factorsNon-cardiac surgery89patients with index scores of 2 or greater were classified as showing some cognitiveimpairment3month0.025
362Postoperative painPostoperative factorsNon-cardiac surgery225If decline inperformance was observed for at least two of threetests on at least one postoperative day,we concludedthat POCD occurred for that patient.1-3day0.22(0.06-0.80)0.02
366Postoperative cerebral blood flowPostoperative factorsCarotid artery stenting(CAS)/carotid endarterectomy(CEA)22summed to generate a total deficit score (TDS)was greaterthen two standard deviations above the mean total cognitive change score of the control group1-3day0.004
408Postoperative painPostoperative factorsNon-cardiac surgery138Z score (at least two Z scores in individualtests or the composite Z score of all variables) at≥1.96,as described in the International Study of Post-Operative CognitiveDysfunction (ISPOCD) before1week0.501(0.267-0.939)0.031
445Postoperative biochemical indexPostoperative factorsHepatobiliary surgery132POCD if their Z scores were≥1.01week1.02(1.01-1.03)0.036
455Postoperative cognitive dysfunctionPostoperative factorsNon-cardiac surgery1218The ISPOCD study identified patients with POCD using a definition based on change from baseline whichconsisted of either a composite Z score of＞2 across tests or two or more tests with Z scores＞21week＜0.05
470Postoperative cognitive dysfunctionPostoperative factorsCardiac Surgery88A patient was classified as having POCD if the Z scores on either two individual tests or thecombined Z score was -1.96 or more negativedischarge2.86(0.99-8.27)＜0.05
475Length Of StayPostoperative factorsNon-cardiac surgery10149(AD8) abnormality (score＞2) and short-term memory impairment presented as 3-Word recall test(TRT) abnormality (score＜3)6month2.43(1.26-4.67)＜0.05
514Postoperative cognitive dysfunctionPostoperative factorsNon-cardiac surgery336Post-operative cognitive dysfunction (POCD) is a condition characterised by impairment of memory and concentration,detected by neuropsychological testing.1-2year2.84(1.35-5.96)0.006
523Other postoperative complicationsPostoperative factorsElective joint arthroplasty (TJA)100we chose to define a significant decline in cognitive function as a decrease in MMSE score of 4 or more 1week0.008
537Postoperative cerebrovascular diseasePostoperative factorsCardiac Surgery400We defined POCD as a decline of one or more of the composite RCI scores that was 1.67 SD orgreater than the mean RCI of the non-surgical participants4-6week0.01
538Postoperative cerebrovascular diseasePostoperative factorsCardiac Surgery400We defined POCD as a decline of one or more of the composite RCI scores that was 1.67 SD orgreater than the mean RCI of the non-surgical participants1year0.05
574Length Of StayPostoperative factorsCardiac Surgery127Cognitive decline was defi ned as a decrease of one standard deviation or more in performance on at least two neurocognitive tests.1week3.83(1.3-11.29)0.015
584Postoperative cognitive dysfunctionPostoperative factorsNon-cardiac surgery219Postoperative decline was defined as a declinein scores of cognitive tests of 25% on 2 of 5 tests.3month5.3(1.8-16)0.002
593Postoperative cerebrovascular diseasePostoperative factorsCardiac Surgery102All analyses were performed using Z scores based on the mean and SD of the preoperative cognitive scores1year＜0.001
599Postoperative biochemical indexPostoperative factorsCardiac Surgery82was defined as a Z score＞1.96 on at least 2 different tests or Telephone Interviews for Cognitive Status-Modified (TICS-M) score＜27.1-3day1.06(1.02-1.11)0.009
601Postoperative cognitive dysfunctionPostoperative factorsCardiac Surgery82was defined as a Z score＞1.96 on at least 2 different tests or Telephone Interviews for Cognitive Status-Modified (TICS-M) score＜27.1month 2.47(1.15-5.29) 0.02
636Postoperative cognitive dysfunctionPostoperative factorsNon-cardiac surgery1277POCD (post-operative cognitive dysfunction) is used to describe a cognitive deterioration that exceeds a 'normal’age- and time-attributed cognitive decline andwhich is caused by negative consequences of peri-operative conditions1week2.56(1.07-6.16)0.035
638Length Of StayPostoperative factorsNon-cardiac surgery1277POCD (post-operative cognitive dysfunction) is used to describe a cognitive deterioration that exceeds a 'normal’age- and time-attributed cognitive decline andwhich is caused by negative consequences of peri-operative conditions1.56(1.00 to 2.42)0.049
645Postoperative cognitive function assessmentPostoperative factorsCardiac 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 postoperatively15month0.462(0.011-0.913)0.045
652Length Of StayPostoperative factorsAbdominal surgery180if the scores on both scales decreased by 1 SD (standard deviation) from thepreoperative level.1week1.71(1.29-2.27)＜0.001
655Postoperative cerebrovascular diseasePostoperative factorscraniocerebral surgery66The 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.discharge0.9＜0.05
656Postoperative cerebrovascular diseasePostoperative factorscraniocerebral surgery66The 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.discharge0.4＜0.05
687Length Of StayPostoperative factorsHepatobiliary surgery80Z score was determined by the followingmethod: ([change score] individual-[mean change score])/(stan-dard deviation change scoretotal) 1week0.032
709Postoperative cognitive dysfunctionPostoperative factorsNon-cardiac surgery921ISPOCD 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.1week9.58(4.62-19.9) ＜0.001
715Postoperative cognitive dysfunctionPostoperative factorsCardiac Surgery184Reliable Change Index (RCI).This approach yields a Z score for every individual test by subtracting from the follow-up score the baseline test score and the mean change on that test in the control group and dividing the result by the SD of the change in the control group1month0.005
720Postoperative cognitive dysfunctionPostoperative factorsCardiac Surgery240Cognitive decline was defined asa decline of one standard deviation or more in performance on one or more of the neuropsychologic tests3month1.31(1.11-1.55)0.002
725Postoperative cognitive dysfunctionPostoperative factorsNon-cardiac surgery560Postoperative cognitive dysfunction was defined as (1) Z scores for two ormore individual tests at or below -1.96 or (2) the sum ofthe seven Z scores (composite Z score) at or below −1.96.1month0.01
726Postoperative cognitive dysfunctionPostoperative factorsNon-cardiac surgery560Postoperative cognitive dysfunction was defined as (1) Z scores for two ormore individual tests at or below -1.96 or (2) the sum ofthe seven Z scores (composite Z score) at or below −1.96.2month0.699
727Postoperative cognitive dysfunctionPostoperative factorsNon-cardiac surgery560Postoperative cognitive dysfunction was defined as (1) Z scores for two ormore individual tests at or below -1.96 or (2) the sum ofthe seven Z scores (composite Z score) at or below −1.96.6month0.489
733Postoperative adjuvant therapyPostoperative factorsAbdominal surgery572If the postoperative score decreased bymore than 2 points compared with the preoperative score,it wasregarded as a decrease in postoperative cognitive function1-3day0.43(0.01∼0.91)0.042
748Postoperative painPostoperative factorsNon-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≤266month3.054(1.936-4.817)＜0.001
782Postoperative painPostoperative factorsElective joint arthroplasty (TJA)105POCD was defined as a postoperative MOCAscore＜26severe POCD was definedas a MOCA score＜201-3day3.111(1.169-8.280)0.023
784Postoperative painPostoperative factorsElective joint arthroplasty (TJA)105POCD was defined as a postoperative MOCAscore＜26severe POCD was definedas a MOCA score＜201-3day9.348(2.539-3.442)0.001
850Postoperative painPostoperative factorsElective joint arthroplasty (TJA)206MMSE＜23 or decreased 2score than M1d1-3day2.364(1.209-4.624)0.012


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