Older patients with documented cognitive impairment also experienced greater postoperative functional decline following elective total knee arthroplasty
To investigate the impact of preoperative cognitive impairment on postoperative outcomes in older patients undergoing elective total knee arthroplasty (TKA).
Key Findings:
Postoperative delirium occurred in 27% of patients with cognitive impairment vs <1% in those without (OR 40.15; 95% CI, 5.3–304.13).
Only 17% of patients with cognitive impairment remained independent postoperatively compared to 48% without (p = 0.029).
50% of patients with cognitive impairment had nonhome discharge vs 36% without.
Interpretation:
Preoperative cognitive impairment is significantly associated with higher rates of postoperative delirium and functional dependence, suggesting the need for early identification and intervention to improve outcomes.
Limitations:
Retrospective observational design may introduce bias.
Cognitive impairment identified through clinical documentation may underestimate true prevalence.
Postoperative delirium assessed via chart audit rather than standardized assessments.
Lack of standardized information regarding postoperative rehabilitation and physical therapy exposure.
Conclusion:
Identifying patients with cognitive impairment preoperatively and implementing preventive strategies may reduce adverse postoperative outcomes.
