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Archivos de Medicina (Manizales)

2022, Número 1

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Arch Med 2022; 22 (1)


Valoración de los trastornos neurocognitivos postoperatorios en estudios clínicos: revisión exploratoria

Rojas GDF, Restrepo BM, Múnera GT, Amaya AJJ, Barrera AJ, Restrepo BD

Idioma: Español
Referencias bibliográficas: 29
Paginas: 145-155
Archivo PDF: 314.25 Kb.


RESUMEN

Objetivo: analizar las definiciones empleadas en estudios clínicos para valorar la recuperación neurocognitiva demorada (RNCd) y los trastornos neurocognitivos menor y mayor postoperatorio (TNCp). Materiales y métodos: revisión exploratoria de la literatura. Se incluyeron estudios clínicos sobre los efectos de la anestesia y cirugía en términos de trastorno neurocognitivo postoperatorio publicados a partir del año 2013 en revistas indizadas en Pubmed o Scopus. Se realizó análisis crítico de los métodos de medición tomando como referencia los criterios planteados en el consenso de nomenclatura. Resultados: se identificaron 13 estudios, cuatro ensayos clínicos aleatorizados y nueve estudios observacionales. Solo tres de estos estudios emplearon definiciones consistentes con el consenso para la RNCd o TNCp. Las principales razones de no adherencia fueron los tiempos de medición y la no exclusión del delirium u otros trastornos mentales como explicación del declive cognitivo. Conclusión: pese a asumir la nomenclatura de trastornos neurocognitivos perioperatorios, los estudios fallaron en adherirse a los tiempos y criterios diagnósticos. Proponemos el desarrollo de un Core Outcome Set como estrategia para avanzar en el propósito de desarrollar evidencia más homogénea, de alta calidad y relevante para la toma de decisiones clínicas.


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