دورية أكاديمية
Associations of an eye-tracking task and pupillary metrics with age and ASA physical status score in a preoperative cohort.
العنوان: | Associations of an eye-tracking task and pupillary metrics with age and ASA physical status score in a preoperative cohort. |
---|---|
المؤلفون: | Papangelou A; Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, USA. apapang@emory.edu., Boorman DW; Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, USA., Sharifpour M; Department of Anesthesiology, Cedars Sinai Medical Center, Los Angeles, CA, USA., Patel HP; Department of Internal Medicine, Wellstar Kennestone Regional Medical Center, Marietta, GA, USA., Cassim T; Department of Anesthesiology, Columbia University, New York, NY, USA., García PS; Department of Anesthesiology, Columbia University, New York, NY, USA. |
المصدر: | Journal of clinical monitoring and computing [J Clin Monit Comput] 2023 Jun; Vol. 37 (3), pp. 795-803. Date of Electronic Publication: 2023 Jan 28. |
نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
اللغة: | English |
بيانات الدورية: | Publisher: Springer Country of Publication: Netherlands NLM ID: 9806357 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-2614 (Electronic) Linking ISSN: 13871307 NLM ISO Abbreviation: J Clin Monit Comput Subsets: MEDLINE |
أسماء مطبوعة: | Publication: Amsterdam : Springer Original Publication: Dordrecht, The Netherlands ; Boston : Kluwer Academic Publishers, c1998- |
مواضيع طبية MeSH: | Neurodegenerative Diseases* , Cognitive Dysfunction*, Humans ; Middle Aged ; Pupil ; Eye-Tracking Technology ; Prospective Studies |
مستخلص: | Advanced age, American Society of Anesthesiologists physical status (ASA) classification and the presence of cognitive impairment are associated with an elevated risk of postoperative morbidity and mortality. The visual paired comparison (VPC) task, which relies on recognition of novel images, examines declarative memory. VPC scores have demonstrated the ability to detect mild cognitive impairment and track progression of neurodegenerative disease. Quantitative pupillometry may have similar value. We evaluate for associations between these variables of interest and the feasibility of performing these tests in the preoperative clinic. Prospective data from 199 patients seen in the preoperative clinic at a tertiary academic center were analyzed. A 5 min VPC task (Neurotrack Technologies, Inc, Redwood City, CA) was administered during their scheduled preoperative clinic visit. Pupillary light reflexes were measured at the same visit (PLR-3000™, Neuroptics Corp, Irvine, California).Thirty-four percent of patients were categorized as ASA 2 and 58% as ASA 3. Median age was 57 (IQR: 44-69). Associations were demonstrated between age and ASA physical status (Mann-Whitney U Test, p < 0.0001), maximum pupil size (Spearman Rank Correlation, r = - 0.40, p < 0.0001), and maximum constriction velocity (Spearman Rank Correlation, r = - 0.39, p < 0.0001). Our data also revealed an association between VPC score and age (Spearman Rank Correlation, p = 0.0016, r = - 0.21) but not ASA score (Kruskal-Wallis Test, p = 0.14). When compared to a nonsurgical cohort with no history of memory impairment, our population scored worse on the VPC task (Mann-Whitney U Test, p = 0.0002). A preoperative 5 min VPC task and pupillometry are feasible tests in the preoperative setting and may provide a valuable window into an individual's cognition prior to elective surgery. (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.) |
References: | Saklad M. Grading of patients for surgical procedures. Anesthesiology. 1941;2:281–4. https://doi.org/10.1097/00000542-194105000-00004 . (PMID: 10.1097/00000542-194105000-00004) Hopkins TJ, Raghunathan K, Barbeito A, Cooter M, Stafford-Smith M, Schroeder R, Grichnik K, Gilbert R, Aronson S. Associations between ASA physical status and postoperative mortality at 48 h: a contemporary dataset analysis compared to a historical cohort. Perioper Med (Lond). 2016;5:29. https://doi.org/10.1186/s13741-016-0054-z . (PMID: 10.1186/s13741-016-0054-z27777754) Davis P, Hayden J, Springer J, Bailey J, Molinari M, Johnson P. Prognostic factors for morbidity and mortality in elderly patients undergoing acute gastrointestinal surgery: a systematic review. Can J Surg. 2014;57:E44-52. https://doi.org/10.1503/cjs.006413 . (PMID: 10.1503/cjs.006413246664593968213) Hernandez BA, Lindroth H, Rowley P, Boncyk C, Raz A, Gaskell A, Garcia PS, Sleigh J, Sanders RD. Post-anaesthesia care unit delirium: incidence, risk factors and associated adverse outcomes. Br J Anaesth. 2017;119:288–90. https://doi.org/10.1093/bja/aex197 . (PMID: 10.1093/bja/aex19728854553) Mayhew D, Mendonca V, Murthy BVS. A review of ASA physical status - historical perspectives and modern developments. Anaesthesia. 2019;74:373–9. https://doi.org/10.1111/anae.14569 . (PMID: 10.1111/anae.1456930648259) O’Reilly-Shah VN, Hemani S, Davari P, Glowka L, Gebhardt E, Hill L, Lee S, Master VA, Rodriguez AD, García PS. A preoperative cognitive screening test predicts increased length of stay in a frail population: a retrospective case-control study. Anesth Analg. 2019;129:1283–90. https://doi.org/10.1213/ane.0000000000004103 . (PMID: 10.1213/ane.0000000000004103308825227877444) Rudolph JL, Marcantonio ER. Review articles: postoperative delirium: acute change with long-term implications. Anesth Analg. 2011;112:1202–11. https://doi.org/10.1213/ANE.0b013e3182147f6d . (PMID: 10.1213/ANE.0b013e3182147f6d214746603090222) Mashour GA, Woodrum DT, Avidan MS. Neurological complications of surgery and anaesthesia. Br J Anaesth. 2015;114:194–203. https://doi.org/10.1093/bja/aeu296 . (PMID: 10.1093/bja/aeu29625204699) Khan MM, Lanctot KL, Fremes SE, Wijeysundera HC, Radhakrishnan S, Gallagher D, Gandell D, Brenkel MC, Hazan EL, Docteur NG, Herrmann N. The value of screening for cognition, depression, and frailty in patients referred for TAVI. Clin Interv Aging. 2019;14:841–8. https://doi.org/10.2147/cia.S201615 . (PMID: 10.2147/cia.S201615311907706512610) Cao SJ, Chen D, Yang L, Zhu T. Effects of an abnormal mini-mental state examination score on postoperative outcomes in geriatric surgical patients: a meta-analysis. BMC Anesthesiol. 2019;19:74. https://doi.org/10.1186/s12871-019-0735-5 . (PMID: 10.1186/s12871-019-0735-5310922066521510) Korc-Grodzicki B, Sun SW, Zhou Q, Iasonos A, Lu B, Root JC, Downey RJ, Tew WP. Geriatric assessment as a predictor of delirium and other outcomes in elderly patients with cancer. Ann Surg. 2015;261:1085–90. https://doi.org/10.1097/sla.0000000000000742 . (PMID: 10.1097/sla.000000000000074224887981) Culley DJ, Flaherty D, Fahey MC, Rudolph JL, Javedan H, Huang CC, Wright J, Bader AM, Hyman BT, Blacker D, Crosby G. Poor performance on a preoperative cognitive screening test predicts postoperative complications in older orthopedic surgical patients. Anesthesiology. 2017;127:765–74. https://doi.org/10.1097/aln.0000000000001859 . (PMID: 10.1097/aln.000000000000185928891828) Heng M, Eagen CE, Javedan H, Kodela J, Weaver MJ, Harris MB. Abnormal mini-cog is associated with higher risk of complications and delirium in geriatric patients with fracture. J Bone Joint Surg Am. 2016;98:742–50. https://doi.org/10.2106/jbjs.15.00859 . (PMID: 10.2106/jbjs.15.0085927147687) Min L, Hall K, Finlayson E, Englesbe M, Palazzolo W, Chan CL, Hou H, Miller A, Diehl KM. Estimating risk of postsurgical general and geriatric complications using the VESPA preoperative tool. JAMA Surg. 2017;152:1126–33. https://doi.org/10.1001/jamasurg.2017.2635 . (PMID: 10.1001/jamasurg.2017.2635287683255831439) Manns JR, Stark CE, Squire LR. The visual paired-comparison task as a measure of declarative memory. Proc Natl Acad Sci U S A. 2000;97:12375–9. https://doi.org/10.1073/pnas.220398097 . (PMID: 10.1073/pnas.2203980971102731017349) Zola SM, Squire LR, Teng E, Stefanacci L, Buffalo EA, Clark RE. Impaired recognition memory in monkeys after damage limited to the hippocampal region. J Neurosci. 2000;20:451–63. https://doi.org/10.1523/jneurosci.20-01-00451.2000 . (PMID: 10.1523/jneurosci.20-01-00451.2000106276216774137) Clark RE, Zola SM, Squire LR. Impaired recognition memory in rats after damage to the hippocampus. J Neurosci. 2000;20:8853–60. https://doi.org/10.1523/jneurosci.20-23-08853.2000 . (PMID: 10.1523/jneurosci.20-23-08853.2000111024946773055) Crutcher MD, Calhoun-Haney R, Manzanares CM, Lah JJ, Levey AI, Zola SM. Eye tracking during a visual paired comparison task as a predictor of early dementia. Am J Alzheimers Dis Other Demen. 2009;24:258–66. https://doi.org/10.1177/1533317509332093 . (PMID: 10.1177/1533317509332093192465732701976) Zola SM, Manzanares CM, Clopton P, Lah JJ, Levey AI. A behavioral task predicts conversion to mild cognitive impairment and Alzheimer’s disease. Am J Alzheimers Dis Other Demen. 2013;28:179–84. https://doi.org/10.1177/1533317512470484 . (PMID: 10.1177/153331751247048423271330) Gills JL, Glenn JM, Madero EN, Bott NT, Gray M. Validation of a digitally delivered visual paired comparison task: reliability and convergent validity with established cognitive tests. Geroscience. 2019;41:441–54. https://doi.org/10.1007/s11357-019-00092-0 . (PMID: 10.1007/s11357-019-00092-0314636496815320) Gills JL, Bott NT, Madero EN, Glenn JM, Gray M. A short digital eye-tracking assessment predicts cognitive status among adults. Geroscience. 2020. https://doi.org/10.1007/s11357-020-00254-5 . (PMID: 10.1007/s11357-020-00254-5328704378050116) Chougule PS, Najjar RP, Finkelstein MT, Kandiah N, Milea D. Light-induced pupillary responses in Alzheimer’s disease. Front Neurol. 2019;10:360. https://doi.org/10.3389/fneur.2019.00360 . (PMID: 10.3389/fneur.2019.00360310316926473037) Frost S, Robinson L, Rowe CC, Ames D, Masters CL, Taddei K, Rainey-Smith SR, Martins RN, Kanagasingam Y. Evaluation of cholinergic deficiency in preclinical Alzheimer’s disease using pupillometry. J Ophthalmol. 2017;2017:7935406. https://doi.org/10.1155/2017/7935406 . (PMID: 10.1155/2017/7935406288946075574262) Fotiou DF, Stergiou V, Tsiptsios D, Lithari C, Nakou M, Karlovasitou A. Cholinergic deficiency in Alzheimer’s and Parkinson’s disease: evaluation with pupillometry. Int J Psychophysiol. 2009;73:143–9. https://doi.org/10.1016/j.ijpsycho.2009.01.011 . (PMID: 10.1016/j.ijpsycho.2009.01.01119414041) Fotiou DF, Brozou CG, Haidich AB, Tsiptsios D, Nakou M, Kabitsi A, Giantselidis C, Fotiou F. Pupil reaction to light in Alzheimer’s disease: evaluation of pupil size changes and mobility. Aging Clin Exp Res. 2007;19:364–71. https://doi.org/10.1007/bf03324716 . (PMID: 10.1007/bf0332471618007114) Van Stavern GP, Bei L, Shui YB, Huecker J, Gordon M. Pupillary light reaction in preclinical Alzheimer’s disease subjects compared with normal ageing controls. Br J Ophthalmol. 2019;103:971–5. https://doi.org/10.1136/bjophthalmol-2018-312425 . (PMID: 10.1136/bjophthalmol-2018-31242530206156) Winn B, Whitaker D, Elliott DB, Phillips NJ. Factors affecting light-adapted pupil size in normal human subjects. Invest Ophthalmol Vis Sci. 1994;35:1132–7. (PMID: 8125724) Yang E, Kreuzer M, Hesse S, Davari P, Lee SC, Garcia PS. Infrared pupillometry helps to detect and predict delirium in the post-anesthesia care unit. J Clin Monit Comput. 2018;32:359–68. https://doi.org/10.1007/s10877-017-0009-z . (PMID: 10.1007/s10877-017-0009-z28275978) Bott NT, Lange A, Rentz D, Buffalo E, Clopton P, Zola S. Web camera based eye tracking to assess visual memory on a visual paired comparison task. Front Neurosci. 2017;11:370. https://doi.org/10.3389/fnins.2017.00370 . (PMID: 10.3389/fnins.2017.00370287019155487587) Bott N, Madero EN, Glenn J, Lange A, Anderson J, Newton D, Brennan A, Buffalo EA, Rentz D, Zola S. Device-embedded cameras for eye tracking-based cognitive assessment: validation with paper-pencil and computerized cognitive composites. J Med Internet Res. 2018;20:e11143. https://doi.org/10.2196/11143 . (PMID: 10.2196/11143300420936081607) Thiagarajan P, Ciuffreda KJ. Pupillary responses to light in chronic non-blast-induced mTBI. Brain Inj. 2015;29:1420–5. https://doi.org/10.3109/02699052.2015.1045029 . (PMID: 10.3109/02699052.2015.104502926182230) Couret D, Boumaza D, Grisotto C, Triglia T, Pellegrini L, Ocquidant P, Bruder NJ, Velly LJ. Reliability of standard pupillometry practice in neurocritical care: an observational, double-blinded study. Crit Care. 2016;20:99. https://doi.org/10.1186/s13054-016-1239-z . (PMID: 10.1186/s13054-016-1239-z270723104828754) Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O’Neal L, McLeod L, Delacqua G, Delacqua F, Kirby J, Duda SN. The REDCap consortium: Building an international community of software platform partners. J Biomed Inform. 2019;95:103208. https://doi.org/10.1016/j.jbi.2019.103208 . (PMID: 10.1016/j.jbi.2019.103208310786607254481) Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377–81. https://doi.org/10.1016/j.jbi.2008.08.010 . (PMID: 10.1016/j.jbi.2008.08.01018929686) Connolly A, Gaehl E, Martin H, Morris J, Purandare N. Underdiagnosis of dementia in primary care: variations in the observed prevalence and comparisons to the expected prevalence. Aging Ment Health. 2011;15:978–84. https://doi.org/10.1080/13607863.2011.596805 . (PMID: 10.1080/13607863.2011.59680521777080) Hess C, Levy B, Hashmi AZ, Hogan J, Greenspan S, Elber A, Falcon K, Driscoll DF. Subjective versus objective assessment of cognitive functioning in primary care. J Am Board Fam Med. 2020;33:417–25. https://doi.org/10.3122/jabfm.2020.03.190265 . (PMID: 10.3122/jabfm.2020.03.19026532430373) Amjad H, Roth DL, Sheehan OC, Lyketsos CG, Wolff JL, Samus QM. Underdiagnosis of dementia: an observational study of patterns in diagnosis and awareness in US older adults. J Gen Intern Med. 2018;33:1131–8. https://doi.org/10.1007/s11606-018-4377-y . (PMID: 10.1007/s11606-018-4377-y295082596025653) Kapoor P, Chen L, Saripella A, Waseem R, Nagappa M, Wong J, Riazi S, Gold D, Tang-Wai DF, Suen C, Englesakis M, Norman R, Sinha SK, Chung F. Prevalence of preoperative cognitive impairment in older surgical patients.: A systematic review and meta-analysis. J Clin Anesth. 2022. https://doi.org/10.1016/j.jclinane.2021.110574 . (PMID: 10.1016/j.jclinane.2021.11057435623265) Bittner DM, Wieseler I, Wilhelm H, Riepe MW, Müller NG. Repetitive pupil light reflex: potential marker in Alzheimer’s disease? J Alzheimers Dis. 2014;42:1469–77. https://doi.org/10.3233/jad-140969 . (PMID: 10.3233/jad-14096925024346) Bilimoria KY, Liu Y, Paruch JL, Zhou L, Kmiecik TE, Ko CY, Cohen ME. Development and evaluation of the universal ACS NSQIP surgical risk calculator: a decision aid and informed consent tool for patients and surgeons. J Am Coll Surg. 2013;217(5):833–42. https://doi.org/10.1016/j.jamcollsurg.2013.07.385 . (PMID: 10.1016/j.jamcollsurg.2013.07.385240553833805776) Litaker D, Locala J, Franco K, Bronson DL, Tannous Z. Preoperative risk factors for postoperative delirium. Gen Hosp Psychiatry. 2001;23:84–9. https://doi.org/10.1016/s0163-8343(01)00117-7 . (PMID: 10.1016/s0163-8343(01)00117-711313076) Yang Y, Zhao X, Dong T, Yang Z, Zhang Q, Zhang Y. Risk factors for postoperative delirium following hip fracture repair in elderly patients: a systematic review and meta-analysis. Aging Clin Exp Res. 2017;29:115–26. https://doi.org/10.1007/s40520-016-0541-6 . (PMID: 10.1007/s40520-016-0541-626873816) Aldecoa C, Bettelli G, Bilotta F, Sanders RD, Audisio R, Borozdina A, Cherubini A, Jones C, Kehlet H, MacLullich A, Radtke F, Riese F, Slooter AJ, Veyckemans F, Kramer S, Neuner B, Weiss B, Spies CD. European society of anaesthesiology evidence-based and consensus-based guideline on postoperative delirium. Eur J Anaesthesiol. 2017;34:192–214. https://doi.org/10.1097/eja.0000000000000594 . (PMID: 10.1097/eja.000000000000059428187050) Deiner S, Silverstein JH. Postoperative delirium and cognitive dysfunction. Br J Anaesth. 2009;103(Suppl 1):i41-46. https://doi.org/10.1093/bja/aep291 . (PMID: 10.1093/bja/aep291200079892791855) Marcantonio ER, Flacker JM, Michaels M, Resnick NM. Delirium is independently associated with poor functional recovery after hip fracture. J Am Geriatr Soc. 2000;48:618–24. https://doi.org/10.1111/j.1532-5415.2000.tb04718.x . (PMID: 10.1111/j.1532-5415.2000.tb04718.x10855596) Neufeld KJ, Leoutsakos JM, Sieber FE, Wanamaker BL, Gibson Chambers JJ, Rao V, Schretlen DJ, Needham DM. Outcomes of early delirium diagnosis after general anesthesia in the elderly. Anesth Analg. 2013;117:471–8. https://doi.org/10.1213/ANE.0b013e3182973650 . (PMID: 10.1213/ANE.0b013e3182973650237574764017627) Safavynia SA, Arora S, Pryor KO, Garcia PS. An update on postoperative delirium: clinical features, neuropathogenesis, and perioperative management. Curr Anesthesiol Rep. 2018;8:252–62. (PMID: 10.1007/s40140-018-0282-5305552816290904) Sprung J, Roberts RO, Weingarten TN, Nunes Cavalcante A, Knopman DS, Petersen RC, Hanson AC, Schroeder DR, Warner DO. Postoperative delirium in elderly patients is associated with subsequent cognitive impairment. Br J Anaesth. 2017;119:316–23. https://doi.org/10.1093/bja/aex130 . (PMID: 10.1093/bja/aex13028854531) Witlox J, Eurelings LS, de Jonghe JF, Kalisvaart KJ, Eikelenboom P, van Gool WA. Delirium in elderly patients and the risk of postdischarge mortality, institutionalization, and dementia: a meta-analysis. JAMA. 2010;304:443–51. https://doi.org/10.1001/jama.2010.1013 . (PMID: 10.1001/jama.2010.101320664045) |
معلومات مُعتمدة: | 220020484 James S. McDonnell Foundation |
فهرسة مساهمة: | Keywords: Cognitive impairment; Maximum constriction velocity; Maximum pupil size; Preoperative; Pupillometer; Visual paired comparison task |
تواريخ الأحداث: | Date Created: 20230128 Date Completed: 20230515 Latest Revision: 20230523 |
رمز التحديث: | 20230523 |
مُعرف محوري في PubMed: | PMC9883606 |
DOI: | 10.1007/s10877-023-00974-x |
PMID: | 36708440 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1573-2614 |
---|---|
DOI: | 10.1007/s10877-023-00974-x |