Recommendations for the Nomenclature of Cognitive Change Associated With Anaesthesia and Surgery-2018.
Level 5 - mechanism / opinion, no new human data
Consensus statement and expert recommendations developed via a modified Delphi process without primary empirical data
PubMed 30325748 · doi:10.1213/ANE.0000000000003634
What was done
A multispecialty working group conducted a modified Delphi procedure comprising three face-to-face meetings followed by online draft editing without a prespecified number of rounds. The objective was to align terminology for cognitive changes after anaesthesia and surgery with classifications used in the general population, specifically DSM-5 and NIA-AA guidelines.
What was found
The abstract reports no numerical data. The working group recommended establishing 'perioperative neurocognitive disorders' as the overarching term. Specific categories include preoperative cognitive decline (neurocognitive disorder), acute postoperative events (postoperative delirium), cognitive decline up to 30 days post-procedure (delayed neurocognitive recovery), and cognitive decline up to 12 months post-procedure (postoperative neurocognitive disorder). DSM-5 nomenclature is recommended for clinical use, with DSM-5 and NIA-AA criteria suggested for biomarker research.
Why it matters
This framework harmonizes perioperative cognitive terminology with standard psychiatric and neurological diagnostic criteria. Aligning classifications helps bridge perioperative research with broader cognitive studies in the general population.
Limits
The document is an expert consensus statement rather than an empirical study. The abstract does not specify the number of participants in the working group, the specific consensus thresholds used during the Delphi process, or empirical validation of the proposed nomenclature.
Cited by
- context Post-operative cognitive dysfunction (POCD) is a recognized clinical concept by both the American Society of Anesthesiologists and the American Psychological Association.