The Association Between Variation in Oxygen Saturation (ScO2) and Incidence of Postoperative Cognitive Dysfunction (POCD) in a Population of Elderly Patients Admitted for Emergency Surgery.

Study Overview
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Brief Summary
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There is no study of the association between ScO2 and POCD in non-cardiac, thoracic or vascular surgery. The few studies found in cardiac, thoracic and vascular surgery show an incidence up to 50% with a variation of the ScO2 threshold which varies between 15 and 25% according to the studies. Age is the main risk of OCDD. The management of this pathology should be early to avoid loss of autonomy of the patient. Finding a relationship, if it exists, would therefore significantly improve the mortality and morbidity of the said patient.

Official Title
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The Association Between Variation in Oxygen Saturation (ScO2) and Incidence of Postoperative Cognitive Dysfunction (POCD) in a Population of Elderly Patients Admitted for Emergency Surgery.

Conditions
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Cerebral Saturation, Cognitive Impairment, Emergencies

Intervention / Treatment
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* Other: To evaluate the relationship between oxygen saturation and the incidence of postoperative cognitive dysfunction in emergency surgery in elderly patients


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥ 65 years Non-cardiac, thoracic and vascular emergency surgery Surgery under general anesthesia ASA I, II or III Simple information without consent Patient affiliated to social security Exclusion Criteria: Inability to understand Patient under tutelage, or curatorship or deprived of public right ASA IV History of severe dementia MMSE <20 Personal or familial history of malignant hyperthermia History of allergy or hypersensitivity to anesthetic products used Contra-indication to Cisatracurium®: myasthenia gravis Contra-indication to Sevoflurane® Contra-indication to local anesthetics Indication of use of a Ketamine®-type hypnotic (modification of the BIS) Indication of use of nitrous oxide History of cranial trauma Neuromuscular pathology Spinal anesthesia Cardiac, thoracic or vascular surgery Surgery not performed in emergency Neurochirugia in the context of cranial trauma Any surgery that does not allow the use of the NIRS (impossibility of positioning of the electrodes by the location of the surgical field).

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Occurrence of postoperative cognitive dysfunction<br> | Other: To evaluate the relationship between oxygen saturation and the incidence of postoperative cognitive dysfunction in emergency surgery in elderly patients<br>* Evaluate the relationship between oxygen saturation and the incidence of postoperative cognitive dysfunction in non-cardiac, thoracic and vascular emergency surgery in patients 65 years of age and older. The occurrence of POCD will be defined by the MMSE decrease of at least 4 points at 24, 48 or 72 hours<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Occurrence of POCD |  | 72 hours |