NLR and PRL in Neurocognitive Disorders

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

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.

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.

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