NLR and PRL in Neurocognitive Disorders

It is estimated that approximately 10% of elderly undergoing surgery will develop cognitive changes perioperatively, while in some reports the incidence rises up to 80%. Despite the reported high prevalence of perioperative neurocognitive disorders (NCD), their exact etiology is still largely unknown.

Preliminary evidence suggest a possible relationship between Neutrophil-Lymphocyte Ratio (NLR) and Platelet-Lymphocyte Ratio (PLR) and perioperative neurocognitive disorders (NCD). We are going to investigate whether the values of NLR and PLR in patients undergoing elective non-cardiac surgery under general anesthesia, are related with increased risk of perioperative NCD.

• NLR (Other): Calculation of NLR
• PLR (Other): Calculation of PLR

Primary outcomes

• Incidence of Postoperative neurocognitive disorders assessed with CAM [1st postoperative day]: Incidence of POD assessed with CAM
• Incidence of Postoperative neurocognitive disorders assessed with IQCODE-16 [10th postoperative day]: Incidence of POCD assessed with IQCODE-16
• Incidence of Postoperative neurocognitive disorders assessed with IQCODE-16 [3 months postoperatively]: Incidence of POCD assessed with IQCODE-16
• Incidence of Postoperative neurocognitive disorders assessed with IQCODE-16 [6 months postoperatively]: Incidence of POCD assessed with IQCODE-16
• Incidence of Postoperative neurocognitive disorders assessed with IQCODE-16 [9 months postoperatively]: Incidence of POCD assessed with IQCODE-16

Sex: All, ages: 45 Years to 80 Years

Inclusion Criteria:

* 45 - 80 years
* American Society of Anesthesiologists physical status I to III
* elective general, urological, gynecological and orthopedic surgery under general anesthesia
* native speakers of the Greek language

Exclusion Criteria:

* refused to participate or sign the informed consent form
* had undergone surgery or anesthesia within the last 30 days
* had any prior or current history involving an affliction of the central nervous system
* were diagnosed with severe cognitive decline based on the 16 - item Informant Questionnaire on Cognitive Decline (IQCODE - 16)
* suffered from severe hearing or visual impairment
* any psychiatric disorder
* had a score >5 in the Geriatric Depression Scale (GDS - 15)
* or a score in females < 4 males < 2 in the Lawton - Brody Instrumental Activities of Daily Living Scale (I.A.D.L.)
* reported alcohol consumption > 35 units/week
* drug dependence
* had undergone previous neuropsychological testing
* Diabetes Mellitus type II with > 10 years of diagnosis
* Diabetes Mellitus type I
* Hemoglobin A1c (HbA1c) > 7.5%
* suffered from hemodynamical instability (> 20% alterations of blood pressure perioperatively)
* or desaturation (one or more events of SpO2 < 80% for more than 2 minutes) peri-operatively
* or blood loss of more than one unit

• Eleni Arnaoutoglou, MD, PhD, Study chair, Professor of Anesthesiology
• Maria Ntalouka, MD, PhD, Principal investigator, Consultant of Anesthesiology