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Infographics in Anesthesiology  |   February 2016
Persistent Postoperative Cognitive Decline?: The Pyramid of Evidence
Author Notes
  • Department of Anesthesiology, Washington University School of Medicine
  • Illustration by Annemarie Johnson, Vivo Visuals.
    Illustration by Annemarie Johnson, Vivo Visuals.×
Article Information
Infographics in Anesthesiology / Geriatric Anesthesia
Infographics in Anesthesiology   |   February 2016
Persistent Postoperative Cognitive Decline?: The Pyramid of Evidence
Anesthesiology 2 2016, Vol.124, A23. doi:10.1097/01.anes.0000476058.02255.81
Anesthesiology 2 2016, Vol.124, A23. doi:10.1097/01.anes.0000476058.02255.81
Complex Information for Anesthesiologists Presented Quickly and Clearly
The hierarchy of evidence showing studies that have found a link (top right) and have not found a link (top left) between surgery or anesthesia and dementia or postoperative cognitive decline (POCD) lasting longer than 6 months. More details and a complete list of the studies referenced can be found in the Editorial View by Avidan and Evers in this issue of Anesthesiology.1  A hypothetical preoperative (Preop) and postoperative (Postop) cognitive trajectory (bottom panel) is illustrated that depicts the course of cognitive decline over time. If a surgical episode occurs at a time when the rate of cognitive decline is already accelerating, postoperative cognitive decline that was already predestined may be mistakenly attributed to surgery. CSHA = Canadian Study on Health and Aging.
Infographic concept and data provided by Michael S. Avidan and Alex S. Evers, Department of Anesthesiology, Washington University School of Medicine. Illustration by Annemarie Johnson, Vivo Visuals.
Avidan, MS, Evers, AS The fallacy of persistent postoperative cognitive decline.. Anesthesiology. (2016). 124 255–8 [Article] [PubMed]