Abstract
<jats:p>Background. Postoperative cognitive impairment is a predictor of persistent cognitive dysfunction and increases the risk of dementia. Over the past two decades, there has been an increase in the number of orthopedic procedures performed under spinal anesthesia for acute trauma or degenerative joint disease. The occurrence of cognitive deficits in the early postoperative period in the elderly is a proven fact. The problem of analyzing diagnostic criteria and adequate neuroprotective correction of postoperative cognitive dysfunction in hip arthroplasty remains not fully resolved. Purpose: to study the negative dynamics of cognitive functions at different times after hip arthroplasty under spinal anesthesia. Materials and methods. The number of patients included in the study was 120. All participants were treated at the trauma unit of the Vinnytsia City Clinical Emergency Hospital. The Mini-Mental State Examination (MMSE) was used as one of the main assessment scales in postoperative cognitive dysfunction. Neurocognitive testing to determine the state of higher nervous activity was performed the day before operation, repeated assessment was carried out on the 4th and 7th days after surgery, and the day before discharge from the hospital. Statistical data processing was performed using the capabilities of spreadsheets of Microsoft Excel and the statistical information processing package SPSS 23.0. Results. In the vast majority (77.1 %) of patients on the 4th day after hip arthroplasty, the negative dynamics of cognitive function was manifested in the form of the appearance of mild cognitive impairment with their absence at the time of hospitalization and the appearance of cognitive disorders of moderate dementia level in the presence of their mild degree at the time of hospitalization. On the 7th day versus the 4th day, a decrease in cases of change in cognitive status is recorded compared to the indicators at the time of hospitalization. And the day before discharge, only 13 out of 35 (37.1 %) cases had negative dynamics of cognitive function; from the total sample, the share of these patients was almost 11 %. Conclusions. Based on the analysis of data on the state of changes in cognitive function, when comparing the postoperative period with the preoperative state, the MMSE in the perioperative period can be used to diagnose cognitive disorders and as a criterion for the effectiveness of correction of cognitive impairment in these patients for the purpose of further therapy.</jats:p>