临床麻醉学杂志：开放获取

The impact of preoperative cognitive screening on postoperative outcomes in elderly surgical patients. Cognitive impairment is common in elderly patients, and surgery can exacerbate this condition. Preoperative cognitive screening has been suggested as a means of identifying paients at risk of postoperative cognitive dysfunction (POCD). This study analyzes the existing literature to examine the effects of preoperative cognitive screening on postoperative outcomes in elderly surgical patients. The study found that preoperative cognitive screening can identify patients at risk of POCD and can be used to optimize perioperative care to reduce the incidence of this condition. Cognitive dysfunction is a significant concern for elderly surgical patients. Postoperative cognitive dysfunction (POCD) is a common complication of surgery, with a reported incidence of up to 50% in elderly patients. POCD can result in decreased quality of life, increased morbidity and mortality, and increased healthcare costs. Several factors contribute to the development of POCD, including anesthesia, surgery, and patient-related factors such as age, comorbidities, and preexisting cognitive impairment.

Simulation-based education (SBE) has been used to enhance clinical decision-making skills among anesthesiology trainees. This systematic review and meta-analysis aimed to examine the effectiveness of SBE in improving the clinical decision-making skills of anesthesiology trainees. A systematic search of relevant studies published in English language was conducted in five electronic databases. Studies reporting the use of SBE in improving the clinical decision-making skills of anesthesiology trainees were included. The Cochrane risk of bias tool was used to assess the quality of included studies. Meta-analysis was performed using random-effects models, and subgroup analyses were conducted based on the type of simulation, type of outcome measures, and level of trainees. Thirteen studies met the inclusion criteria, and the overall quality of evidence was moderate to high. Meta-analysis showed a statistically significant improvement in clinical decisionmaking skills among anesthesiology trainees who received SBE compared to those who received traditional education (standardized mean difference 0.74, 95% CI 0.50 to 0.98, p<0.001). Subgroup analyses suggested that high-fidelity simulation and objective outcome measures were more effective in improving clinical decision-making skills. This study provides evidence to support the use of SBE in improving the clinical decision-making skills of anesthesiology trainees.