Correlation of Preoperative Anxiety With Early Postoperative Cognitive Dysfunction in Breast Cancer Patients
Condition: Postoperative Cognitive Dysfunction; Preoperative Anxiety
MeSH terms: Postoperative Cognitive Complications; Anxiety Disorders; Cognitive Dysfunction
Study type: Observational [Patient Registry]

Summary: 
      Breast cancer is the most common type of cancer in women. Anxiety and depression often
      accompany the treatment phase of oncology patients.

      Since both anxiety and depression are associated with increased inflammatory activity, these
      preoperative symptoms may predispose patients to the development of postoperative
      neurocognitive dysfunction.

      The aim of this study is to reveal the correlation of preoperative anxiety with early
      postoperative cognitive dysfunction in patients with breast cancer who will undergo surgery.
    

Detailed description: 
      During the treatment of oncological disease, %13-19 of these patients show symptoms of
      anxiety and depression.Although many factors affect the development of postoperative
      cognitive dysfunction, there are several well-known risk factors and are thought to be due to
      increased inflammatory activity. Inflammation and immune dysfunction are common in
      oncological patients. It has also been reported that the presence of increased central
      nervous system inflammatory reactivity affects cognitive function.Since both anxiety and
      depression are associated with increased inflammatory activity, these preoperative symptoms
      may predispose patients to the development of postoperative neurocognitive dysfunction.

      Postoperative cognitive dysfunction is an unwanted postoperative condition and is thought to
      be particularly relevant to elderly patients. Most studies in the literature have focused on
      the elderly. However, younger patients tend to experience more anxiety and depression during
      cancer treatment.

      Studies indicate that age is inversely correlated with emotional distress and younger
      patients tend to experience higher levels of anxiety during diagnosis and treatment.

      Also, younger patients have more limited life experiences to help them cope with such
      traumatic situations. The preoperative anxiety rate was found twice as high in female
      patients compared to male patients. Younger patients with bone cancer, breast cancer, and
      prostate cancer were three times more likely to report anxiety among the tumor groups than
      older patients.

      Although the definition, degree and duration of postoperative cognitive dysfunction have been
      well researched, the effect of preoperative anxiety on the development of postoperative
      cognitive dysfunction has not been studied in detail.

      Patients who are scheduled for elective breast surgery will be included in the study, who are
      informed and agree to participate in the study.

      From the beginning of the study, consecutive patients will be included in the
      study.Preoperative MoCA test and State-Trait Anxiety Inventory Test (STAI FORM) questionnaire
      form will be filled in with the patient through one-on-one interview and in the early
      postoperative period. After the test ASA scores, age, comorbidities, demographic data,
      education levels, duration of anesthesia and surgery, and vital parameters will be recorded.

      (1st week) MoCA test will be applied and its relationship with POCD will be checked.

      Patients with preoperative MoCA score (M0) 21/30 points and above; It will be re-evaluated on
      the 7th postoperative day (M1) and a 4 unit decrease in M1 score from M0 score will be
      considered as POCD.

      The correlation between preoperative anxiety level and early postoperative cognitive
      dysfunction (POCD) will be investigated.
    

Intervention name(s): MoCA test
Intervention type(s): Diagnostic Test
Intervention description(s): Preoperative MoCA test and State-Trait Anxiety Inventory Test (STAI FORM ) questionnaire form will be filled in female patients between the ages of 18-65 by making a one-on-one interview with the patient and the MoCA test will be applied in the early postoperative period (1st week) to ensure its relationship with POCD will be checked.
Observational model: Other
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Female patients aged 18-65 years who are scheduled for elective surgery due to breast
        malignancy who meet the inclusion criteria