APOE gene polymorphism as a potential predictor of postoperative cognitive dysfunction in colon cancer surgery under general anesthesia

Dalibor Bošković; Sanja  Marić; Nenad  Lalović; Srdjan  Mašić; Nikolina  Elez-Burnjaković; Rade  Miletić; Dragan  Spaić; Jelena  Krunić

doi:10.2298/VSP241009025B

Dalibor Bošković Hospital East Sarajevo, Department of Anesthesiology and Intensive Care, East Sarajevo, Republic of Srpska, Bosnia and Herzegovina
Sanja Marić University Hospital, †Department of Anesthesiology and Intensive Care, ‡Department of Surgery, Republic of Srpska, Bosnia and Herzegovina
Nenad Lalović University of East Sarajevo, Faculty of Medicine, ‡Department of Surgery, Foča, Republic of Srpska, Bosnia and Herzegovina; Clinic of Surgery, Foča, Republic of Srpska, Bosnia and Herezgovina
Srdjan Mašić University of East Sarajevo, Faculty of Medicine, Department of Primary Health Care and Public Health, Foča, Republic of Srpska, Bosnia and Herzegovina
Nikolina Elez-Burnjaković University of East Sarajevo, Faculty of Medicine, Department of Cell Biology and Human Genetics, Foča, Republic of Srpska, Bosnia and Herzegovina
Rade Miletić University Hospital, Clinic of Surgery, Foča, Republic of Srpska, Bosnia and Herezgovina; University of East Sarajevo, Faculty of Medicine, ‡Department of Surgery, Foča, Republic of Srpska, Bosnia and Herzegovina
Dragan Spaić University of East Sarajevo, Faculty of Medicine, Department of Primary Health Care and Public Health, Foča, Republic of Srpska, Bosnia and Herzegovina
Jelena Krunić University of East Sarajevo, Faculty of Medicine, Department of Dental Pathology, Foča, Republic of Srpska, Bosnia and Herzegovina

DOI: https://doi.org/10.2298/VSP241009025B

Keywords: anesthesia, general;, cognitive dysfunction;, colonic neoplasms;, prognosis;, psychological tests

Abstract

Background/Aim. Postoperative cognitive dysfunction (POCD) occurs very often in operated patients. This increasingly frequent complication compromises the recovery of operated patients, impairs the quality of life of patients and their families, prolongs the length of hospital stay, and increases the cost of treatment. The aim of the study was to examine the association between the apolipoprotein E (APOE) ε4 allele and sociodemographic and clinical characteristics with the occurrence of POCD seven days and three months after colon cancer surgery (CCS) under general anesthesia (GA). Methods. A total of 113 patients aged 18 to 87 years who underwent CCS under GA in the period from 2021 to 2023 participated in the study. Preoperative preparation, anesthesia, and postoperative treatment were uniform and standardized for all patients. The assessment of cognitive status was conducted using the Mini Mental State Examination psychometric test on the day before surgery, on the seventh postoperative day, and three months after surgery. Results. Seven days after surgery, a statistically significant impairment of cognitive functions was found in patients with the APOE ε4 allele in their genotype (p = 0.007). Patients 65 years old or above were more likely to have POCD three months after surgery compared to younger patients (80.0% vs. 52.9%; p = 0.003). Conclusion. The presence of the APOE ε4 allele is a potential predictor of the occurrence of POCD seven days after surgery, and age is a significant sociodemographic factor for the occurrence of POCD three months after CCS is performed under GA.

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