Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery—2018

The Nomenclature Consensus Working Group

Research output: Contribution to journalArticle

Abstract

Cognitive change affecting patients after anaesthesia and surgery has been recognised for more than 100 yr. Research into cognitive change after anaesthesia and surgery accelerated in the 1980s when multiple studies utilised detailed neuropsychological testing for assessment of cognitive change after cardiac surgery. This body of work consistently documented decline in cognitive function in elderly patients after anaesthesia and surgery, and cognitive changes have been identified up to 7.5 yr afterwards. Importantly, other studies have identified that the incidence of cognitive change is similar after non-cardiac surgery. Other than the inclusion of non-surgical control groups to calculate postoperative cognitive dysfunction, research into these cognitive changes in the perioperative period has been undertaken in isolation from cognitive studies in the general population. The aim of this work is to develop similar terminology to that used in cognitive classifications of the general population for use in investigations of cognitive changes after anaesthesia and surgery. A multispecialty working group followed a modified Delphi procedure with no prespecified number of rounds comprised of three face-to-face meetings followed by online editing of draft versions. Two major classification guidelines [Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM-5) and National Institute for Aging and the Alzheimer Association (NIA-AA)] are used outside of anaesthesia and surgery, and may be useful for inclusion of biomarkers in research. For clinical purposes, it is recommended to use the DSM-5 nomenclature. The working group recommends that ‘perioperative neurocognitive disorders’ be used as an overarching term for cognitive impairment identified in the preoperative or postoperative period. This includes cognitive decline diagnosed before operation (described as neurocognitive disorder); any form of acute event (postoperative delirium) and cognitive decline diagnosed up to 30 days after the procedure (delayed neurocognitive recovery) and up to 12 months (postoperative neurocognitive disorder).

Original languageEnglish (US)
Pages (from-to)1473-1480
Number of pages8
JournalActa Anaesthesiologica Scandinavica
Volume62
Issue number10
DOIs
StatePublished - Nov 1 2018

Fingerprint

Terminology
Anesthesia
Research
Preoperative Period
Perioperative Period
Delirium
Postoperative Period
Diagnostic and Statistical Manual of Mental Disorders
Cognition
Population
Thoracic Surgery
Biomarkers
Guidelines
Control Groups
Incidence
Cognitive Dysfunction
Neurocognitive Disorders

Keywords

  • cognition disorders
  • delirium
  • neurocognitive disorders
  • postoperative complications

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery—2018. / The Nomenclature Consensus Working Group.

In: Acta Anaesthesiologica Scandinavica, Vol. 62, No. 10, 01.11.2018, p. 1473-1480.

Research output: Contribution to journalArticle

@article{3db0df7bc9524553bb87c46eb05be02d,
title = "Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery—2018",
abstract = "Cognitive change affecting patients after anaesthesia and surgery has been recognised for more than 100 yr. Research into cognitive change after anaesthesia and surgery accelerated in the 1980s when multiple studies utilised detailed neuropsychological testing for assessment of cognitive change after cardiac surgery. This body of work consistently documented decline in cognitive function in elderly patients after anaesthesia and surgery, and cognitive changes have been identified up to 7.5 yr afterwards. Importantly, other studies have identified that the incidence of cognitive change is similar after non-cardiac surgery. Other than the inclusion of non-surgical control groups to calculate postoperative cognitive dysfunction, research into these cognitive changes in the perioperative period has been undertaken in isolation from cognitive studies in the general population. The aim of this work is to develop similar terminology to that used in cognitive classifications of the general population for use in investigations of cognitive changes after anaesthesia and surgery. A multispecialty working group followed a modified Delphi procedure with no prespecified number of rounds comprised of three face-to-face meetings followed by online editing of draft versions. Two major classification guidelines [Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM-5) and National Institute for Aging and the Alzheimer Association (NIA-AA)] are used outside of anaesthesia and surgery, and may be useful for inclusion of biomarkers in research. For clinical purposes, it is recommended to use the DSM-5 nomenclature. The working group recommends that ‘perioperative neurocognitive disorders’ be used as an overarching term for cognitive impairment identified in the preoperative or postoperative period. This includes cognitive decline diagnosed before operation (described as neurocognitive disorder); any form of acute event (postoperative delirium) and cognitive decline diagnosed up to 30 days after the procedure (delayed neurocognitive recovery) and up to 12 months (postoperative neurocognitive disorder).",
keywords = "cognition disorders, delirium, neurocognitive disorders, postoperative complications",
author = "{The Nomenclature Consensus Working Group} and Lis Evered and Brendan Silbert and Knopman, {David S.} and Scott, {David A.} and DeKosky, {Steven T.} and Rasmussen, {Lars S.} and Esther Oh and Greg Crosby and Miles Berger and Eckenhoff, {R. G.} and David Ames and Chan, {Harvard TH} and Deiner, {Stacie G.} and Diederikvan Dijk and Lars Eriksson and Dougas Galasko and Kirk Hogan and Sharon Inouye and Lyketsos, {Constantine G} and Edward cantonio and Paul Maruff and Mervyn Maze and Orser, {Beverley A.} and Thomas Ottens and Catherine Price and Perminder Sachdev and Katie Schenning and Seiber, {Frederick E.} and Jeff Silverstein and Jacob Steinmetz and Niccolo Terrando and Paula Trzapacz and Rob Whittington and Zhongcong Xie",
year = "2018",
month = "11",
day = "1",
doi = "10.1111/aas.13250",
language = "English (US)",
volume = "62",
pages = "1473--1480",
journal = "Acta Anaesthesiologica Scandinavica",
issn = "0001-5172",
publisher = "Blackwell Munksgaard",
number = "10",

}

TY - JOUR

T1 - Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery—2018

AU - The Nomenclature Consensus Working Group

AU - Evered, Lis

AU - Silbert, Brendan

AU - Knopman, David S.

AU - Scott, David A.

AU - DeKosky, Steven T.

AU - Rasmussen, Lars S.

AU - Oh, Esther

AU - Crosby, Greg

AU - Berger, Miles

AU - Eckenhoff, R. G.

AU - Ames, David

AU - Chan, Harvard TH

AU - Deiner, Stacie G.

AU - Dijk, Diederikvan

AU - Eriksson, Lars

AU - Galasko, Dougas

AU - Hogan, Kirk

AU - Inouye, Sharon

AU - Lyketsos, Constantine G

AU - cantonio, Edward

AU - Maruff, Paul

AU - Maze, Mervyn

AU - Orser, Beverley A.

AU - Ottens, Thomas

AU - Price, Catherine

AU - Sachdev, Perminder

AU - Schenning, Katie

AU - Seiber, Frederick E.

AU - Silverstein, Jeff

AU - Steinmetz, Jacob

AU - Terrando, Niccolo

AU - Trzapacz, Paula

AU - Whittington, Rob

AU - Xie, Zhongcong

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Cognitive change affecting patients after anaesthesia and surgery has been recognised for more than 100 yr. Research into cognitive change after anaesthesia and surgery accelerated in the 1980s when multiple studies utilised detailed neuropsychological testing for assessment of cognitive change after cardiac surgery. This body of work consistently documented decline in cognitive function in elderly patients after anaesthesia and surgery, and cognitive changes have been identified up to 7.5 yr afterwards. Importantly, other studies have identified that the incidence of cognitive change is similar after non-cardiac surgery. Other than the inclusion of non-surgical control groups to calculate postoperative cognitive dysfunction, research into these cognitive changes in the perioperative period has been undertaken in isolation from cognitive studies in the general population. The aim of this work is to develop similar terminology to that used in cognitive classifications of the general population for use in investigations of cognitive changes after anaesthesia and surgery. A multispecialty working group followed a modified Delphi procedure with no prespecified number of rounds comprised of three face-to-face meetings followed by online editing of draft versions. Two major classification guidelines [Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM-5) and National Institute for Aging and the Alzheimer Association (NIA-AA)] are used outside of anaesthesia and surgery, and may be useful for inclusion of biomarkers in research. For clinical purposes, it is recommended to use the DSM-5 nomenclature. The working group recommends that ‘perioperative neurocognitive disorders’ be used as an overarching term for cognitive impairment identified in the preoperative or postoperative period. This includes cognitive decline diagnosed before operation (described as neurocognitive disorder); any form of acute event (postoperative delirium) and cognitive decline diagnosed up to 30 days after the procedure (delayed neurocognitive recovery) and up to 12 months (postoperative neurocognitive disorder).

AB - Cognitive change affecting patients after anaesthesia and surgery has been recognised for more than 100 yr. Research into cognitive change after anaesthesia and surgery accelerated in the 1980s when multiple studies utilised detailed neuropsychological testing for assessment of cognitive change after cardiac surgery. This body of work consistently documented decline in cognitive function in elderly patients after anaesthesia and surgery, and cognitive changes have been identified up to 7.5 yr afterwards. Importantly, other studies have identified that the incidence of cognitive change is similar after non-cardiac surgery. Other than the inclusion of non-surgical control groups to calculate postoperative cognitive dysfunction, research into these cognitive changes in the perioperative period has been undertaken in isolation from cognitive studies in the general population. The aim of this work is to develop similar terminology to that used in cognitive classifications of the general population for use in investigations of cognitive changes after anaesthesia and surgery. A multispecialty working group followed a modified Delphi procedure with no prespecified number of rounds comprised of three face-to-face meetings followed by online editing of draft versions. Two major classification guidelines [Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM-5) and National Institute for Aging and the Alzheimer Association (NIA-AA)] are used outside of anaesthesia and surgery, and may be useful for inclusion of biomarkers in research. For clinical purposes, it is recommended to use the DSM-5 nomenclature. The working group recommends that ‘perioperative neurocognitive disorders’ be used as an overarching term for cognitive impairment identified in the preoperative or postoperative period. This includes cognitive decline diagnosed before operation (described as neurocognitive disorder); any form of acute event (postoperative delirium) and cognitive decline diagnosed up to 30 days after the procedure (delayed neurocognitive recovery) and up to 12 months (postoperative neurocognitive disorder).

KW - cognition disorders

KW - delirium

KW - neurocognitive disorders

KW - postoperative complications

UR - http://www.scopus.com/inward/record.url?scp=85051782872&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85051782872&partnerID=8YFLogxK

U2 - 10.1111/aas.13250

DO - 10.1111/aas.13250

M3 - Article

VL - 62

SP - 1473

EP - 1480

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

SN - 0001-5172

IS - 10

ER -