Can surgery lead to cognitive problems?


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4 comments

  1. Mike Fraumeni

    There are risks with any medical procedure or treatments and as the last line from this excellent article reads “those benefits will likely outweigh any possible memory deficits.” Medicine like all applied sciences is not an exact entity and no one should be under the false belief it is. It’s all a personal decision as to undergoing surgery and thankfully our fantastic physicians and research teams are trying to make all medical procedures safer and more effective for everyone.

  2. Andreas laupacis

    Thanks Paul. I enjoyed reading this.

    I am trying to reconcile two comments in this article: a) Dr. Orser’s statement that “…between 10 and 20 percent of patients will have problems [cognitive impairment] at the time they are discharged from hospital,” and “… one in 10 of those affected will still have problems three to six months later.” and b) Dr Choi’s comment that “… the risk of possible cognitive impairment is not a good enough reason to forgo an operation. After all, the goal of most surgeries is to improve a patient’s quality of life….”

    Boy, a 20% risk of cognitive impairment, with 10% of those continuing on for 3-6 months sounds like a pretty big negative hit on quality of life to me, and might make me delay a hip or knee joint replacement until my pain is really, really bad.

    I always assumed that if i had a spinal anesthetic (instead of a general) for my knee replacement that the impact on my cognition would be less. It sounds like you are saying that assumption is wrong….

    • Paul Taylor

      One thing to keep in mind is that hospitals are now discharging people earlier
      than they did years ago.
      That trend might partly explain why the numbers look high at time of
      discharge. Within a few days, many would likely return to a normal state.

      (I recently had surgery to repair a broken elbow. For the procedure, I was put under a full anaesthetic and I was discharged from hospital the same day. I noticed no impairment but some of the changes are so subtle that they are only picked up with cognitive tests. )

      Also, 10 per cent of the 10 per cent affected (going on the low side of the estimate)
      is just one per cent of all patients at the 3 to 6 month point.

      So, it’s not a big number in a relative sense, but when you consider how many people get surgery each year it’s still significant.

  3. Vivian

    Recently had major surgery – was in hospital two weeks before abd one week after. Definitely the lack of sleep due to hospital setting, pain, discomfort, nightly nurse checks, blood draws – can disorient anyone!! The side effects of not only anaesthetics but of the pain meds, narcotic, anti nauseantS, antibiotics etc also contribute!! Perhaps offering more quiet at night, brain stimulation in day with activities or books etc, minimize disruption to a normal daily activities may help!

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