BIS index monitoring and perioperative neurocognitive disorders in older adults: a systematic review and meta-analysis
Background and aims Perioperative neurocognitive disorders (PND) are common in elderly patients after surgery. It has been reported that BIS-guided anesthesia potentially influenced the occurrence of PND. Therefore, we conducted this systematic review and meta-analysis to explore the associations be...
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| Veröffentlicht in: | Aging clinical and experimental research 2020-12, Vol.32 (12), p.2449-2458 |
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| creator | Miao, Mengrong Xu, Yuehua Sun, Mingyang Chang, Enqiang Cong, Xuhui Zhang, Jiaqiang |
| description | Background and aims
Perioperative neurocognitive disorders (PND) are common in elderly patients after surgery. It has been reported that BIS-guided anesthesia potentially influenced the occurrence of PND. Therefore, we conducted this systematic review and meta-analysis to explore the associations between bispectral index (BIS) monitoring and PND.
Methods
Two researchers independently searched for relevant randomized controlled trials (RCTs) in PubMed, EMBASE, and the Cochrane Library (CENTRAL) using keywords related to the BIS and PND from inception to April 22, 2019. Odds ratios (OR) with 95% CI were calculated using a random effects model.
Results
Nine RCTs involving 4023 participants aged 60 years or older were included into this meta-analysis. BIS-guided anesthesia was not associated with lower incidence of POD (random effects; OR: 0.69; 95% CI 0.48, 1.01), delayed neurocognitive recovery (DNR) at 1 day, 7 days (random effects; OR: 0.14; 95% CI 0.02, 1.23; random effects; OR: 0.97; 95% CI 0.57, 1.63), and postoperative neurocognitive disorder (NCD) at 90 days and 1 year after surgery in older adults (random effects; OR:0.72; 95% CI 0.52, 1.00; random effects; OR: 0.26; 95% CI 0.03, 2.47).
Conclusions
No definite evidence demonstrated that BIS-guided anesthesia decreased the incidence of POD, DNR and postoperative NCD in older patients. More homogeneous RCTs assessing the efficacy of BIS monitoring on reducing the occurrence of these perioperative cognitive disorders are needed. |
| doi_str_mv | 10.1007/s40520-019-01433-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2329730413</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2473362897</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-7c5eadd19f08b522817f10c683780b95b9429a6153ddc0fd7ea3071f9f2ef8ea3</originalsourceid><addsrcrecordid>eNp9kU9PGzEQxa2qqKRpvwCHylIvXLb4z268yw0QtJGQOABny1nPRka769SzG5Jv3wlJS8WBg8cz1u89W36MnUjxQwphzjAXhRKZkBWtXOts84FNpKGjUsvq43_9MfuM-CRELmn4xI61LGeayoStL-f3PPQeNryLfRhiCv2Su97zFaQQqbghrIH3MKZYxyUhu9EHjMlDQtLy2FLHnR_bAc-547jFATrS1TzBOsDzi18Hg8tc79otBvzCjhrXInw97FP2eHP9cPUru737Ob-6uM1qbYohM3UBzntZNaJcFEqV0jRS1LNSm1IsqmJR5apyM1lo72vReANOCyObqlHQlDRM2ened5Xi7xFwsF3AGtrW9RBHtEqryujdvxD6_Q36FMdE7yUqN1rPVEnolKk9VaeImKCxqxQ6l7ZWCrtLxe5TsZSKfUnFbkj07WA9Ljrw_yR_YyBA7wFc7f4f0uvd79j-AXEOmgg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2473362897</pqid></control><display><type>article</type><title>BIS index monitoring and perioperative neurocognitive disorders in older adults: a systematic review and meta-analysis</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Miao, Mengrong ; Xu, Yuehua ; Sun, Mingyang ; Chang, Enqiang ; Cong, Xuhui ; Zhang, Jiaqiang</creator><creatorcontrib>Miao, Mengrong ; Xu, Yuehua ; Sun, Mingyang ; Chang, Enqiang ; Cong, Xuhui ; Zhang, Jiaqiang</creatorcontrib><description>Background and aims
Perioperative neurocognitive disorders (PND) are common in elderly patients after surgery. It has been reported that BIS-guided anesthesia potentially influenced the occurrence of PND. Therefore, we conducted this systematic review and meta-analysis to explore the associations between bispectral index (BIS) monitoring and PND.
Methods
Two researchers independently searched for relevant randomized controlled trials (RCTs) in PubMed, EMBASE, and the Cochrane Library (CENTRAL) using keywords related to the BIS and PND from inception to April 22, 2019. Odds ratios (OR) with 95% CI were calculated using a random effects model.
Results
Nine RCTs involving 4023 participants aged 60 years or older were included into this meta-analysis. BIS-guided anesthesia was not associated with lower incidence of POD (random effects; OR: 0.69; 95% CI 0.48, 1.01), delayed neurocognitive recovery (DNR) at 1 day, 7 days (random effects; OR: 0.14; 95% CI 0.02, 1.23; random effects; OR: 0.97; 95% CI 0.57, 1.63), and postoperative neurocognitive disorder (NCD) at 90 days and 1 year after surgery in older adults (random effects; OR:0.72; 95% CI 0.52, 1.00; random effects; OR: 0.26; 95% CI 0.03, 2.47).
Conclusions
No definite evidence demonstrated that BIS-guided anesthesia decreased the incidence of POD, DNR and postoperative NCD in older patients. More homogeneous RCTs assessing the efficacy of BIS monitoring on reducing the occurrence of these perioperative cognitive disorders are needed.</description><identifier>ISSN: 1720-8319</identifier><identifier>ISSN: 1594-0667</identifier><identifier>EISSN: 1720-8319</identifier><identifier>DOI: 10.1007/s40520-019-01433-x</identifier><identifier>PMID: 31863318</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Aged ; Algorithms ; Anesthesia ; Central Nervous System Diseases ; Clinical trials ; Cognition Disorders ; Delirium ; Geriatrics/Gerontology ; Humans ; Medicine ; Medicine & Public Health ; Meta-analysis ; Older people ; Postoperative Period ; Review ; Surgery ; Systematic review</subject><ispartof>Aging clinical and experimental research, 2020-12, Vol.32 (12), p.2449-2458</ispartof><rights>Springer Nature Switzerland AG 2019</rights><rights>Springer Nature Switzerland AG 2019.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-7c5eadd19f08b522817f10c683780b95b9429a6153ddc0fd7ea3071f9f2ef8ea3</citedby><cites>FETCH-LOGICAL-c375t-7c5eadd19f08b522817f10c683780b95b9429a6153ddc0fd7ea3071f9f2ef8ea3</cites><orcidid>0000-0002-6956-8599</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s40520-019-01433-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s40520-019-01433-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31863318$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Miao, Mengrong</creatorcontrib><creatorcontrib>Xu, Yuehua</creatorcontrib><creatorcontrib>Sun, Mingyang</creatorcontrib><creatorcontrib>Chang, Enqiang</creatorcontrib><creatorcontrib>Cong, Xuhui</creatorcontrib><creatorcontrib>Zhang, Jiaqiang</creatorcontrib><title>BIS index monitoring and perioperative neurocognitive disorders in older adults: a systematic review and meta-analysis</title><title>Aging clinical and experimental research</title><addtitle>Aging Clin Exp Res</addtitle><addtitle>Aging Clin Exp Res</addtitle><description>Background and aims
Perioperative neurocognitive disorders (PND) are common in elderly patients after surgery. It has been reported that BIS-guided anesthesia potentially influenced the occurrence of PND. Therefore, we conducted this systematic review and meta-analysis to explore the associations between bispectral index (BIS) monitoring and PND.
Methods
Two researchers independently searched for relevant randomized controlled trials (RCTs) in PubMed, EMBASE, and the Cochrane Library (CENTRAL) using keywords related to the BIS and PND from inception to April 22, 2019. Odds ratios (OR) with 95% CI were calculated using a random effects model.
Results
Nine RCTs involving 4023 participants aged 60 years or older were included into this meta-analysis. BIS-guided anesthesia was not associated with lower incidence of POD (random effects; OR: 0.69; 95% CI 0.48, 1.01), delayed neurocognitive recovery (DNR) at 1 day, 7 days (random effects; OR: 0.14; 95% CI 0.02, 1.23; random effects; OR: 0.97; 95% CI 0.57, 1.63), and postoperative neurocognitive disorder (NCD) at 90 days and 1 year after surgery in older adults (random effects; OR:0.72; 95% CI 0.52, 1.00; random effects; OR: 0.26; 95% CI 0.03, 2.47).
Conclusions
No definite evidence demonstrated that BIS-guided anesthesia decreased the incidence of POD, DNR and postoperative NCD in older patients. More homogeneous RCTs assessing the efficacy of BIS monitoring on reducing the occurrence of these perioperative cognitive disorders are needed.</description><subject>Aged</subject><subject>Algorithms</subject><subject>Anesthesia</subject><subject>Central Nervous System Diseases</subject><subject>Clinical trials</subject><subject>Cognition Disorders</subject><subject>Delirium</subject><subject>Geriatrics/Gerontology</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Older people</subject><subject>Postoperative Period</subject><subject>Review</subject><subject>Surgery</subject><subject>Systematic review</subject><issn>1720-8319</issn><issn>1594-0667</issn><issn>1720-8319</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kU9PGzEQxa2qqKRpvwCHylIvXLb4z268yw0QtJGQOABny1nPRka769SzG5Jv3wlJS8WBg8cz1u89W36MnUjxQwphzjAXhRKZkBWtXOts84FNpKGjUsvq43_9MfuM-CRELmn4xI61LGeayoStL-f3PPQeNryLfRhiCv2Su97zFaQQqbghrIH3MKZYxyUhu9EHjMlDQtLy2FLHnR_bAc-547jFATrS1TzBOsDzi18Hg8tc79otBvzCjhrXInw97FP2eHP9cPUru737Ob-6uM1qbYohM3UBzntZNaJcFEqV0jRS1LNSm1IsqmJR5apyM1lo72vReANOCyObqlHQlDRM2ened5Xi7xFwsF3AGtrW9RBHtEqryujdvxD6_Q36FMdE7yUqN1rPVEnolKk9VaeImKCxqxQ6l7ZWCrtLxe5TsZSKfUnFbkj07WA9Ljrw_yR_YyBA7wFc7f4f0uvd79j-AXEOmgg</recordid><startdate>20201201</startdate><enddate>20201201</enddate><creator>Miao, Mengrong</creator><creator>Xu, Yuehua</creator><creator>Sun, Mingyang</creator><creator>Chang, Enqiang</creator><creator>Cong, Xuhui</creator><creator>Zhang, Jiaqiang</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6956-8599</orcidid></search><sort><creationdate>20201201</creationdate><title>BIS index monitoring and perioperative neurocognitive disorders in older adults: a systematic review and meta-analysis</title><author>Miao, Mengrong ; Xu, Yuehua ; Sun, Mingyang ; Chang, Enqiang ; Cong, Xuhui ; Zhang, Jiaqiang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-7c5eadd19f08b522817f10c683780b95b9429a6153ddc0fd7ea3071f9f2ef8ea3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Algorithms</topic><topic>Anesthesia</topic><topic>Central Nervous System Diseases</topic><topic>Clinical trials</topic><topic>Cognition Disorders</topic><topic>Delirium</topic><topic>Geriatrics/Gerontology</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Older people</topic><topic>Postoperative Period</topic><topic>Review</topic><topic>Surgery</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Miao, Mengrong</creatorcontrib><creatorcontrib>Xu, Yuehua</creatorcontrib><creatorcontrib>Sun, Mingyang</creatorcontrib><creatorcontrib>Chang, Enqiang</creatorcontrib><creatorcontrib>Cong, Xuhui</creatorcontrib><creatorcontrib>Zhang, Jiaqiang</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Aging clinical and experimental research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Miao, Mengrong</au><au>Xu, Yuehua</au><au>Sun, Mingyang</au><au>Chang, Enqiang</au><au>Cong, Xuhui</au><au>Zhang, Jiaqiang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>BIS index monitoring and perioperative neurocognitive disorders in older adults: a systematic review and meta-analysis</atitle><jtitle>Aging clinical and experimental research</jtitle><stitle>Aging Clin Exp Res</stitle><addtitle>Aging Clin Exp Res</addtitle><date>2020-12-01</date><risdate>2020</risdate><volume>32</volume><issue>12</issue><spage>2449</spage><epage>2458</epage><pages>2449-2458</pages><issn>1720-8319</issn><issn>1594-0667</issn><eissn>1720-8319</eissn><abstract>Background and aims
Perioperative neurocognitive disorders (PND) are common in elderly patients after surgery. It has been reported that BIS-guided anesthesia potentially influenced the occurrence of PND. Therefore, we conducted this systematic review and meta-analysis to explore the associations between bispectral index (BIS) monitoring and PND.
Methods
Two researchers independently searched for relevant randomized controlled trials (RCTs) in PubMed, EMBASE, and the Cochrane Library (CENTRAL) using keywords related to the BIS and PND from inception to April 22, 2019. Odds ratios (OR) with 95% CI were calculated using a random effects model.
Results
Nine RCTs involving 4023 participants aged 60 years or older were included into this meta-analysis. BIS-guided anesthesia was not associated with lower incidence of POD (random effects; OR: 0.69; 95% CI 0.48, 1.01), delayed neurocognitive recovery (DNR) at 1 day, 7 days (random effects; OR: 0.14; 95% CI 0.02, 1.23; random effects; OR: 0.97; 95% CI 0.57, 1.63), and postoperative neurocognitive disorder (NCD) at 90 days and 1 year after surgery in older adults (random effects; OR:0.72; 95% CI 0.52, 1.00; random effects; OR: 0.26; 95% CI 0.03, 2.47).
Conclusions
No definite evidence demonstrated that BIS-guided anesthesia decreased the incidence of POD, DNR and postoperative NCD in older patients. More homogeneous RCTs assessing the efficacy of BIS monitoring on reducing the occurrence of these perioperative cognitive disorders are needed.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>31863318</pmid><doi>10.1007/s40520-019-01433-x</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-6956-8599</orcidid></addata></record> |
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| ispartof | Aging clinical and experimental research, 2020-12, Vol.32 (12), p.2449-2458 |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Aged Algorithms Anesthesia Central Nervous System Diseases Clinical trials Cognition Disorders Delirium Geriatrics/Gerontology Humans Medicine Medicine & Public Health Meta-analysis Older people Postoperative Period Review Surgery Systematic review |
| title | BIS index monitoring and perioperative neurocognitive disorders in older adults: a systematic review and meta-analysis |
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