Effect of central sensitization on postoperative cognitive dysfunction in total knee arthroplasty patients: a retrospective study
BackgroundPostoperative cognitive dysfunction (POCD) is a common complication after total knee arthroplasty (TKA), impacting recovery and quality of life. This study aims to investigate central sensitization (CS) as an independent risk factor for POCD to improve preoperative screening and postoperat...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2024.1509197/full |
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| author | Qiqi Yang Qiqi Yang Chunning Li Min Ye Xinhua Zhou Xinhua Zhou Weiran Li Fei Li Fei Li |
| author_facet | Qiqi Yang Qiqi Yang Chunning Li Min Ye Xinhua Zhou Xinhua Zhou Weiran Li Fei Li Fei Li |
| author_sort | Qiqi Yang |
| collection | DOAJ |
| description | BackgroundPostoperative cognitive dysfunction (POCD) is a common complication after total knee arthroplasty (TKA), impacting recovery and quality of life. This study aims to investigate central sensitization (CS) as an independent risk factor for POCD to improve preoperative screening and postoperative interventions.MethodsA retrospective analysis was conducted on 142 TKA patients from January 2020 to May 2024 across three hospitals. Data were collected at six time points: preoperatively (T0), intraoperatively (T1), and postoperatively on days 1 (T2), 3 (T3), 7 (T4), and 30 (T5). Patients were classified into CS (CSI ≥ 40) and non-CS (CSI < 40) groups according to Central Sensitization Inventory (CSI) score. Cognitive function and POCD incidence were assessed with the Mini-Mental State Examination (MMSE), and knee recovery with the Knee Injury and Osteoarthritis Outcome Score (KOOS). Logistic regression was used to identified risk factors for POCD.ResultsThe overall incidence of POCD at T5 was 19.72%, with a significantly higher rate in CS group (30.91%) compared to non-CS group (12.64%) (p = 0.008). MMSE scores declined significantly in both groups at T2 and T3 compared to T0 (p < 0.05), with CS group showing consistently lower scores than non-CS group at T2-T5 (p < 0.05). KOOS scores revealed that CS group had worse pain and quality of life scores at T0, T4, and T5 compared with non-CS group (p < 0.05). Logistic regression revealed that CS, cerebrovascular disease, intraoperative hemorrhage, and preoperative MMSE were associated with the risk of POCD (p < 0.05).ConclusionCS is a significant risk factor for POCD following TKA, adversely affecting recovery in terms of pain and quality of life. Prospective studies are warranted to validate findings and develop targeted interventions. |
| format | Article |
| id | doaj-art-e2fe5bbd1da84ff1b8f216b2c88cc937 |
| institution | Kabale University |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj-art-e2fe5bbd1da84ff1b8f216b2c88cc9372025-01-15T05:10:22ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-01-011510.3389/fneur.2024.15091971509197Effect of central sensitization on postoperative cognitive dysfunction in total knee arthroplasty patients: a retrospective studyQiqi Yang0Qiqi Yang1Chunning Li2Min Ye3Xinhua Zhou4Xinhua Zhou5Weiran Li6Fei Li7Fei Li8Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, ChinaThe First Clinical Medical School, Anhui University of Chinese Medicine, Hefei, ChinaSecond Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, ChinaThe First Clinical Medical School, Anhui University of Chinese Medicine, Hefei, ChinaSecond Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, ChinaFirst Affiliated Hospital of Bengbu Medical College, Bengbu, ChinaSecond Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, ChinaSecond Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, ChinaHefei Southeast Orthopedics Hospital, Hefei, ChinaBackgroundPostoperative cognitive dysfunction (POCD) is a common complication after total knee arthroplasty (TKA), impacting recovery and quality of life. This study aims to investigate central sensitization (CS) as an independent risk factor for POCD to improve preoperative screening and postoperative interventions.MethodsA retrospective analysis was conducted on 142 TKA patients from January 2020 to May 2024 across three hospitals. Data were collected at six time points: preoperatively (T0), intraoperatively (T1), and postoperatively on days 1 (T2), 3 (T3), 7 (T4), and 30 (T5). Patients were classified into CS (CSI ≥ 40) and non-CS (CSI < 40) groups according to Central Sensitization Inventory (CSI) score. Cognitive function and POCD incidence were assessed with the Mini-Mental State Examination (MMSE), and knee recovery with the Knee Injury and Osteoarthritis Outcome Score (KOOS). Logistic regression was used to identified risk factors for POCD.ResultsThe overall incidence of POCD at T5 was 19.72%, with a significantly higher rate in CS group (30.91%) compared to non-CS group (12.64%) (p = 0.008). MMSE scores declined significantly in both groups at T2 and T3 compared to T0 (p < 0.05), with CS group showing consistently lower scores than non-CS group at T2-T5 (p < 0.05). KOOS scores revealed that CS group had worse pain and quality of life scores at T0, T4, and T5 compared with non-CS group (p < 0.05). Logistic regression revealed that CS, cerebrovascular disease, intraoperative hemorrhage, and preoperative MMSE were associated with the risk of POCD (p < 0.05).ConclusionCS is a significant risk factor for POCD following TKA, adversely affecting recovery in terms of pain and quality of life. Prospective studies are warranted to validate findings and develop targeted interventions.https://www.frontiersin.org/articles/10.3389/fneur.2024.1509197/fullcentral sensitizationpostoperative cognitive dysfunctiontotal knee arthroplastyretrospective studyMini-Mental State ExaminationKnee Injury and Osteoarthritis Outcome Score |
| spellingShingle | Qiqi Yang Qiqi Yang Chunning Li Min Ye Xinhua Zhou Xinhua Zhou Weiran Li Fei Li Fei Li Effect of central sensitization on postoperative cognitive dysfunction in total knee arthroplasty patients: a retrospective study Frontiers in Neurology central sensitization postoperative cognitive dysfunction total knee arthroplasty retrospective study Mini-Mental State Examination Knee Injury and Osteoarthritis Outcome Score |
| title | Effect of central sensitization on postoperative cognitive dysfunction in total knee arthroplasty patients: a retrospective study |
| title_full | Effect of central sensitization on postoperative cognitive dysfunction in total knee arthroplasty patients: a retrospective study |
| title_fullStr | Effect of central sensitization on postoperative cognitive dysfunction in total knee arthroplasty patients: a retrospective study |
| title_full_unstemmed | Effect of central sensitization on postoperative cognitive dysfunction in total knee arthroplasty patients: a retrospective study |
| title_short | Effect of central sensitization on postoperative cognitive dysfunction in total knee arthroplasty patients: a retrospective study |
| title_sort | effect of central sensitization on postoperative cognitive dysfunction in total knee arthroplasty patients a retrospective study |
| topic | central sensitization postoperative cognitive dysfunction total knee arthroplasty retrospective study Mini-Mental State Examination Knee Injury and Osteoarthritis Outcome Score |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2024.1509197/full |
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