biostudies-literatureLi DSichuan Provincial Science and Technology Support ProgramSichuan Provincial People's Hospital Research Fund35https://www.ebi.ac.uk/biostudies/studies/S-EPMC11779751biostudies-literatureUnknown37(1)<h4>Objective</h4>The primary goal was to investigate whether the presence of preoperative lacunar infarcts (LACI) was associated with postoperative delirium (POD) in elderly patients undergoing elective major abdominal surgery.<h4>Design</h4>A prospective cohort study.<h4>Setting and participants</h4>Patients aged ≥ 65 years from a tertiary level A hospital in China.<h4>Methods</h4>The POD was assessed once daily within the first postoperative 3 days using the Confusion Assessment Method. Neurocognitive tests using the Mini-mental State Examination (MMSE) and the Beijing version of the Montreal Cognitive Assessment scales were carried out within 3 days before surgery and 4-7 days after surgery. Regional cerebral oxygen saturation (rScO₂) was recorded in the operating room. Logistic regression analysis was used to evaluate the impact of preoperative LACI on POD and to explore the risk factors for POD.<h4>Results</h4>A total of 369 participants were analyzed, 161 in the preoperative LACI-positive group (P group), and 208 in the preoperative LACI-negative group (N group), respectively. The incidence of POD was 32.7% in our study. The incidence of POD was significantly higher in the P group than in the N group (39.1 vs 27.9%, risk ratio, 1.66; 95% CI 1.07-2.58; P = 0.022). Furthermore, the P group exhibited lower mean rScO₂ values during the procedure (P < 0.001). In exploratory analysis, the advanced age (P = 0.005), sex (P = 0.038), and lower preoperative MMSE score (P = 0.019) were independent risk factors for POD in patients undergoing major abdominal surgery.<h4>Conclusions and implications</h4>Preoperative LACI was common, and constituted a risk factor for POD in older patients undergoing abdominal surgery. Despite the frequent subclinical nature, the preoperative LACI led to lower mean rScO₂ during the procedure. These findings could help early identification of high-risk POD patients.Aging clinical and experimental researchThe association between preoperative lacunar infarcts and postoperative delirium in elderly patients undergoing major abdominal surgery: a prospective cohort study.PMC117797512020LY102022YF S0302Yao YLi DGu PWang YFan DfalseThe association between preoperative lacunar infarcts and postoperative delirium in elderly patients undergoing major abdominal surgery: a prospective cohort study.<h4>Objective</h4>The primary goal was to investigate whether the presence of preoperative lacunar infarcts (LACI) was associated with postoperative delirium (POD) in elderly patients undergoing elective major abdominal surgery.<h4>Design</h4>A prospective cohort study.<h4>Setting and participants</h4>Patients aged ≥ 65 years from a tertiary level A hospital in China.<h4>Methods</h4>The POD was assessed once daily within the first postoperative 3 days using the Confusion Assessment Method. Neurocognitive tests using the Mini-mental State Examination (MMSE) and the Beijing version of the Montreal Cognitive Assessment scales were carried out within 3 days before surgery and 4-7 days after surgery. Regional cerebral oxygen saturation (rScO₂) was recorded in the operating room. Logistic regression analysis was used to evaluate the impact of preoperative LACI on POD and to explore the risk factors for POD.<h4>Results</h4>A total of 369 participants were analyzed, 161 in the preoperative LACI-positive group (P group), and 208 in the preoperative LACI-negative group (N group), respectively. The incidence of POD was 32.7% in our study. The incidence of POD was significantly higher in the P group than in the N group (39.1 vs 27.9%, risk ratio, 1.66; 95% CI 1.07-2.58; P = 0.022). Furthermore, the P group exhibited lower mean rScO₂ values during the procedure (P < 0.001). In exploratory analysis, the advanced age (P = 0.005), sex (P = 0.038), and lower preoperative MMSE score (P = 0.019) were independent risk factors for POD in patients undergoing major abdominal surgery.<h4>Conclusions and implications</h4>Preoperative LACI was common, and constituted a risk factor for POD in older patients undergoing abdominal surgery. Despite the frequent subclinical nature, the preoperative LACI led to lower mean rScO₂ during the procedure. These findings could help early identification of high-risk POD patients.2025-01-01T00:00:00Z2025 Jan2025-04-05T09:33:23.756Z2025-04-05T09:33:23.756ZS-EPMC117797513987891910.1007/s40520-024-02909-1