INDEPENDENCE OF AGE AND SURGICAL DURATION AS PREDICTORS OF POSTOPERATIVE COGNITIVE DECLINE IN SCHOOL-AGE CHILDREN: A DUAL-FACTOR ANALYSIS
Keywords:
Kalit so'zlar: perioperative neurocognitive disorder, age, anesthesia duration, confounding, multivariate risk model, statistical independence, school-age children.Abstract
Abstract: Age and surgical/anesthesia duration are both established risk factors for perioperative neurocognitive disorder (PND) in children, but their potential interdependence — whether older children simply tend to undergo longer procedures, confounding interpretation of each factor's individual contribution — has rarely been explicitly tested. Among 181 operated children aged 7–17 years (mean age 11.5 ± 3.2) from the Tashkent Pediatric Medical Institute clinic, the correlation between age and anesthesia duration was tested directly, followed by separate correlation analyses of each factor against the composite postoperative cognitive index and domain-specific neuropsychological scores. Age and anesthesia duration showed a negligible correlation with one another (r = +0.054; p = 0.474), confirming their statistical independence. Anesthesia duration correlated inversely with the composite cognitive index (r = −0.495; p < 0.001) and most strongly with verbal memory (r = −0.499; p < 0.001) and psychomotor speed (r = −0.487; p < 0.001), while age correlated positively with the composite cognitive index (r = +0.440; p < 0.001) in the opposite, protective direction. These findings validate the simultaneous inclusion of age and anesthesia duration as separate, non-redundant variables in multifactorial perioperative neurocognitive risk models, as confirmed by their independent significance (OR = 0.67 and OR = 1.02, respectively; both p < 0.001) in the four-factor logistic regression model derived from this cohort.
References
REFERENCES:
U.S. Food and Drug Administration. FDA Drug Safety Communication: FDA review results in new warnings about using general anesthetics and sedation drugs in young children and pregnant women. — 2016 (updated 2017, 2022).
Andropoulos D.B., Greene M.F. Anesthesia and Developing Brains — Implications of the FDA Warning // New England Journal of Medicine. — 2017. — Vol. 376, № 10. — P. 905–907.
Fan C.-H., Peng B., Zhang F.-C. The postoperative effect of sevoflurane inhalational anesthesia on cognitive function and inflammatory response of pediatric patients // European Review for Medical and Pharmacological Sciences. — 2018. — Vol. 22, № 12. — P. 3971–3975.
Tang X. et al. Predictors and occurrence of postoperative cognitive dysfunction in children undergoing noncardiac surgery: A prospective cohort study. — 2023.
Reighard C., Junaid S., Jackson W.M. et al. Anesthetic Exposure During Childhood and Neurodevelopmental Outcomes: A Systematic Review and Meta-analysis // JAMA Network Open. — 2022. — Vol. 5, № 6. — e2217427.
Zakirova D.A., Madjidova Y.N. Dissertation materials: Clinical-neurological characteristics and early detection of perioperative neurocognitive disorders in school-age children following surgical procedures. — Tashkent, 2025.
