NLR and PRL in Neurocognitive Disorders

Study Overview
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Brief Summary
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Preliminary evidence suggest a possible relationship between Neutrophil-Lymphocyte Ratio (NLR) and Platelet-Lymphocyte Ratio (PLR) and perioperative neurocognitive disorders (NCD). We are going to investigate whether the values of NLR and PLR in patients undergoing elective non-cardiac surgery under general anesthesia, are related with increased risk of perioperative NCD.

Detailed Description
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It is estimated that approximately 10% of elderly undergoing surgery will develop cognitive changes perioperatively, while in some reports the incidence rises up to 80%. Despite the reported high prevalence of perioperative neurocognitive disorders (NCD), their exact etiology is still largely unknown. Preliminary evidence suggest a possible relationship between Neutrophil-Lymphocyte Ratio (NLR) and Platelet-Lymphocyte Ratio (PLR) and perioperative neurocognitive disorders (NCD). We are going to investigate whether the values of NLR and PLR in patients undergoing elective non-cardiac surgery under general anesthesia, are related with increased risk of perioperative NCD.

Official Title
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The Effect of NLR and PLR on Perioperative Neurocognitive Disorders in Patients Undergoing Elective Non-cardiac Surgery Under General Anesthesia.

Conditions
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Neurocognitive Disorders, Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio

Intervention / Treatment
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* Other: NLR
* Other: PLR


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 45 - 80 years American Society of Anesthesiologists physical status I to III elective general, urological, gynecological and orthopedic surgery under general anesthesia native speakers of the Greek language Exclusion Criteria: refused to participate or sign the informed consent form had undergone surgery or anesthesia within the last 30 days had any prior or current history involving an affliction of the central nervous system were diagnosed with severe cognitive decline based on the 16 - item Informant Questionnaire on Cognitive Decline (IQCODE - 16) suffered from severe hearing or visual impairment any psychiatric disorder had a score >5 in the Geriatric Depression Scale (GDS - 15) or a score in females < 4 males < 2 in the Lawton - Brody Instrumental Activities of Daily Living Scale (I.A.D.L.) reported alcohol consumption > 35 units/week drug dependence had undergone previous neuropsychological testing Diabetes Mellitus type II with > 10 years of diagnosis Diabetes Mellitus type I Hemoglobin A1c (HbA1c) > 7.5% suffered from hemodynamical instability (> 20% alterations of blood pressure perioperatively) or desaturation (one or more events of SpO2 < 80% for more than 2 minutes) peri-operatively or blood loss of more than one unit

Ages Eligible for Study
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Minimum Age: 45 Years
Maximum Age: 80 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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Noncardiac surgery<br>Calculation of the NLR and PLR in patients undergoing noncardiac surgery under general anesthesia | Other: NLR<br>* Calculation of NLR<br>Other: PLR<br>* Calculation of PLR<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of Postoperative neurocognitive disorders assessed with CAM | Incidence of POD assessed with CAM | 1st postoperative day | 
| Incidence of Postoperative neurocognitive disorders assessed with IQCODE-16 | Incidence of POCD assessed with IQCODE-16 | 10th postoperative day | 
| Incidence of Postoperative neurocognitive disorders assessed with IQCODE-16 | Incidence of POCD assessed with IQCODE-16 | 3 months postoperatively | 
| Incidence of Postoperative neurocognitive disorders assessed with IQCODE-16 | Incidence of POCD assessed with IQCODE-16 | 6 months postoperatively | 
| Incidence of Postoperative neurocognitive disorders assessed with IQCODE-16 | Incidence of POCD assessed with IQCODE-16 | 9 months postoperatively | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Neurocognitive disorders, Neutrophil-Lymphocyte ratio, Platelet-Lymphocyte ratio