Lokhorst, M. (Marien) (2016) Postoperatieve cognitieve dysfunctie bij oudere kankerpatiënten (PICNIC): Het effect van perioperatieve bloedtransfusies op inflammatie en postoperatieve cognitieve dysfunctie. thesis, Medicine.
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Abstract
Background: In an ageing population, where elderly keep getting older, cancer is a more often occurring health problem. Surgical treatment of malignant tumours is therefore performed in an increasing frequency. Postoperative cognitive dysfunction (POCD) is a known complication, which may greatly impact the quality of life of elderly patients. The inflammatory response on a surgical procedure is currently presumed to be a causative factor of POCD. There are many different factors that play a role in the degree of inflammation that develops in response to surgery. Perioperative allogenic blood transfusions induce an immunological reaction and are therefore a possible influencing factor. By altering the inflammatory response, allogenic blood transfusions may contribute to POCD. Objectives: In this study, the effect of perioperative allogenic blood transfusions on postoperative cognitive functioning is investigated. Methods: Data from the PICNIC study is used; a prospective observational study, executed at the UMCG from 2010 to 2014. Patients were followed during an oncologic-surgical treatment, where levels of inflammation were determined using different biomarkers. Blood loss and blood transfusions were registered perioperatively. Cognitive functioning was assessed pre- and postoperatively using a neuropsychological test battery; Rey’s Auditory Verbal Learning Test, Ruff’s Figural Fluency Test and the Trailmaking Test part A and B. Results: Data from 248 patients were analyzed. 12,6% of the patients had POCD two weeks postoperatively and 6,9% three months postoperatively. A significant association was found between POCD and age, gender, blood loss and total number of blood transfusions. Also, POCD at two weeks postoperatively was significantly associated with POCD three months postoperatively. Furthermore, the administration of one or more blood transfusions was significantly associated with a postoperative rise in IL-6 and IL-10. In contrast with previous studies, no significant correlation was found between inflammation and postoperative cognitive functioning. Conclusions: Based on the results, indications were found that perioperative allogenic blood transfusions do affect postoperative cognitive functioning in elderly cancer patients. In contrast with previous studies, no significant correlation between inflammation and postoperative cognitive functioning was found. Secondary results showed that the administration of allogenic blood transfusions was significantly associated with a postoperative rise in IL-6 and IL-10.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider: and Absalom, Prof. dr. A.R. and Dagelijks begeleider: and Rotteveel, E. MSc. and Universitair Medisch Centrum Groningen and Afdeling Anesthesiologie |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:39 |
| Last Modified: | 25 Jun 2020 10:39 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/131 |
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