Effect of noise isolation on postoperative delirium in elderly patients undergoing hip surgery: protocol for a randomised controlled trial DOI Creative Commons
Chun Yang,

Min-yuan Zhuang,

Xian Chen

et al.

BMJ Open, Journal Year: 2025, Volume and Issue: 15(4), P. e088092 - e088092

Published: April 1, 2025

Introduction Postoperative delirium (POD) is a frequent complication in elderly surgical patients, leading to increased morbidity and mortality. Previous studies have shown that noise isolation associated with reduced incidence of the intensive care unit (ICU). This trial aims evaluate impact using noise-cancelling headphones on POD patients undergoing hip surgery. Methods analysis In this randomised controlled trial, total 320 will be group or control group, 1:1 ratio stratified by age (65‒80 years >80 years), type surgery (fracture non-fracture) planned ICU admission (yes no). For used throughout anaesthesia postoperative ICU. Patients routinely managed exposed clinical environment. The primary outcome during 0‒7 days after before hospital discharge, assessed 3 min Confusion Assessment Method for Intensive Care Unit. secondary outcomes include pain at 6, 24 48 hours surgery; sleep quality first second nights nausea vomiting within postoperatively; cognitive function mortality 30 Ethics dissemination was approved Committee First Affiliated Hospital Soochow University (Approval No. 2024–054). results submitted peer review publication scientific journal. Trial registration number Chinese Clinical Registry (ChiCTR2400082211).

Language: Английский

The Prevention and Treatment of Postoperative Delirium in the Elderly: A Narrative Systematic Review of Reviews DOI
Simon Deblois, Nicolas Bergeron, Thien Tuong Minh Vu

et al.

Journal of Patient Safety, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 29, 2025

Objectives: Postoperative delirium (POD) is a common complication after major surgeries, posing significant challenges to patient recovery and outcomes, particularly among the elderly. A narrative systematic review was conducted assess clinical effectiveness safety of interventions aimed at preventing treating POD. Methods: literature from 2017 September 29, 2023, using MEDLINE, EMBASE, CINAHL. Systematic reviews, with or without meta-analyses, as well practice guidelines, were included. Participants adults, ≥60 years. The methodological quality included reviews appraised AMSTAR 2. Results: After search strategy identified 2295 references, 36 studies selected. Multicomponent interventions, incorporating both pharmacological nonpharmacological approaches, demonstrate promise, in hip fracture patients. Notably, dexmedetomidine emerges potential preventive measure, showing notable reduction incidence following cardiac surgery. While several show potential, evidence remains inconclusive, necessitating further investigation. Similarly, varying anesthesia type monitoring methods has mixed outcomes on prevention. Despite variations appraisal limitations, this underscores importance multicomponent efficacy mitigating Integration evidence-based protocols into advocated improve outcomes. However, complex interplay between intervention components calls for research optimize management strategies. Conclusions: strength associated use should require genuine commitment health care institutions support their integration efficient strategies prevent treat Ongoing vital uncover full refine protocols, ultimately enhancing

Language: Английский

Citations

1
Bibliometric Analysis of Neuroinflammation and Postoperative Cognitive Dysfunction DOI Creative Commons
Zheping Chen,

Zhenxiang Zuo,

Yizheng Zhang

et al.

Brain and Behavior, Journal Year: 2025, Volume and Issue: 15(1)

Published: Jan. 1, 2025

ABSTRACT Background The occurrence and development of postoperative cognitive dysfunction (POCD) are closely linked to neuroinflammation. This bibliometric analysis aims provide novel insights into the research trajectory, key topics, potential future trends in field neuroinflammation‐induced POCD. Methods Web Science Core Collection (WoSCC) database was searched identify publications from 2012 2023 on Bibliometric analysis, involving both statistical visual analyses, conducted using CiteSpace, VOSviewer, R software. Results Research POCD has exhibited an increasing trend over past 12 years. China had highest number publications, Nanjing Medical University most collaboration with other institutions, Zhiyi Zuo published author, Journal Neuroinflammation served as primary publication frequent keyword Keyword clustering indicated that predominant cluster is dexmedetomidine. Burst detection revealed delirium (POD), perioperative neurocognitive disorders (PND), apoptosis, epigenetic modifications were trends. Conclusions Our identified following areas associated POCD: anesthesia, surgery, dexmedetomidine, NLRP3 inflammasome, mechanism topics comprise POD, PND, modifications.

Language: Английский

Citations

0
The immune-inflammatory responses on the hypothalamic-pituitary-adrenal axis and the neurovascular unit in perioperative neurocognitive disorder DOI
So Yeong Cheon,

M Cho,

So Yeon Kim

et al.

Experimental Neurology, Journal Year: 2025, Volume and Issue: 386, P. 115146 - 115146

Published: Jan. 11, 2025

Language: Английский

Citations

0
The effect of anesthesia on postoperative cognitive dysfunction in adults undergoing cataract surgery: a systematic review DOI Creative Commons

E Foroughi,

Etrusca Brogi, Francesco Forfori

et al.

BMC Anesthesiology, Journal Year: 2025, Volume and Issue: 25(1)

Published: Jan. 23, 2025

We systematically reviewed the evidence on effect of anesthetic methods and drugs incidence postoperative cognitive dysfunction (POCD) after cataract surgery. The Web Science, PubMed, Scopus databases were searched for relevant English reports published from 2000 to August 2024. After full-text screening checking quality assessment each article using JBI checklist, 9 articles included in this study. explain how different modalities may affect POCD Our study aimed investigate relationship between various anesthesia people undergoing clinical trials with 1014 participants, which analyzed interventions. Four compared modality interventions five studies POCD. used measurement scales, including Mini-Mental State Examination, Neurobehavioral Rating Scale, Blessed Orientation-Memory-Concentration Test, Iowa Satisfaction Anesthesia scale, PALT, VF test. All that local topical found no statistically significant difference at postop days 1 7. General cause approximately twofold than anesthesia. Ketamine, Midazolam, or Dexmedetomidine seemed reduce complications control group‌‌. This systematic review investigates techniques available literature is far being conclusive further are needed reach any conclusions. It necessary adopt an appropriate method elderly high-risk patients, especially who have a history problems‌‌ elective surgery, surgery.‌

Language: Английский

Citations

0
Macrophage migration inhibitory factor in the mouse hippocampus promotes neuroinflammation and cognitive dysfunction following anesthesia and surgery DOI
Lian Zeng,

Pengchao Hu,

Yu Zhang

et al.

International Immunopharmacology, Journal Year: 2025, Volume and Issue: 151, P. 114351 - 114351

Published: Feb. 24, 2025

Language: Английский

Citations

0
Predicting postoperative cognitive dysfunction in older cardiac surgery patients: An integrated machine learning approach with a visual nomogram DOI Creative Commons
Ming Sang, Jianhua Wei,

Fengxia Weng

et al.

Research Square (Research Square), Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 27, 2025

Abstract Objectives This study integrated machine learning algorithms to identify key risk factors for postoperative cognitive dysfunction (POCD) in older cardiac surgery patients. aimed develop a predictive nomogram assist clinicians and nurses identifying high-risk patients implementing targeted interventions. Methods A prospective cohort was conducted with 353 admitted the surgical intensive care unit (ICU). Data on demographics, laboratory results, clinical characteristics were collected. The least absolute shrinkage selection operator (LASSO) regression applied determine most relevant predictors POCD. These incorporated into multivariate logistic model construct nomogram. Model performance assessed using receiver operating characteristic (ROC) curve analysis, calibration curves, decision analysis. Results POCD observed 49.86% of Seven independent identified: approach, pre-existing comorbidities, operation duration, intraoperative blood loss, sleep quality score during ICU stay, Acute Physiology Chronic Health Evaluation II (APACHE II), self-care ability. nomogram; it demonstrated robust an area under ROC (AUC) 0.786. exhibited excellent discrimination. Decision analysis confirmed its utility across broad range threshold probabilities. Conclusions precise effective developed Underlying quality, APACHE II, ability as Implications Clinical Practice provides valuable tool early detection prevention POCD, enabling make informed decisions tailor Its application can help reduce incidence ultimately improving patient outcomes care.

Language: Английский

Citations

0
Postoperative Delirium and Cognitive Dysfunction After Cardiac Surgery: The Role of Inflammation and Clinical Risk Factors DOI Creative Commons

Raluca-Elisabeta Staicu,

Corina Vernic, Sebastian Ciurescu

et al.

Diagnostics, Journal Year: 2025, Volume and Issue: 15(7), P. 844 - 844

Published: March 26, 2025

Background/Objectives: Postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) are prevalent neurological complications following cardiac surgery, significantly affecting patient recovery long-term outcomes, including increased risk of persistent impairment, functional decline, mortality. Understanding the underlying mechanisms factors for POD/POCD is crucial improving perioperative management. This study aimed to investigate relationship between systemic inflammation, assessed through inflammatory markers, occurrence POD POCD in patients undergoing surgery. Methods: We prospectively enrolled 88 aged 18-79 years open-heart Patients with preoperative impairment or high surgical (based on EuroSCORE SOFA scores) were excluded focus impact inflammation a relatively unselected cohort. responses (CRP, NLR, IL-6, IL-17A, SII, SIRI) measured, (CAM-ICU) (neuropsychological testing) during hospitalization at 3 months follow-up. Statistical comparisons performed who developed those did not. Results: was confirmed across cohort, significant increases CRP, SIRI. While correlational analyses changes individual markers not statistically entire exhibited higher levels IL-6 NLR 48 h postoperatively (p < 0.05). Established clinical associated included older age, prolonged cardiopulmonary bypass (CPB) duration, extended mechanical ventilation, vasopressor support blood transfusion, renal dysfunction, elevated creatine kinase (CK) lactate dehydrogenase (LDH) Ejection fraction (EF) 45% atrial fibrillation (AF) also more group. Conclusions: Our findings emphasize role response, particularly conjunction established factors, development after levels, readily measurable cost-effective may contribute identifying risk. Comprehensive management strategies targeting modifiable organ function mitigating outcomes this vulnerable population.

Language: Английский

Citations

0
Prevalence of postoperative neurocognitive disorders in older non-cardiac surgical patients: A systematic review and meta-analysis DOI Creative Commons
Wei Huang,

Shirley Fan,

Weiqin Li

et al.

Journal of Clinical Anesthesia, Journal Year: 2025, Volume and Issue: 103, P. 111830 - 111830

Published: April 1, 2025

Language: Английский

Citations

0
Effect of noise isolation on postoperative delirium in elderly patients undergoing hip surgery: protocol for a randomised controlled trial DOI Creative Commons
Chun Yang,

Min-yuan Zhuang,

Xian Chen

et al.

BMJ Open, Journal Year: 2025, Volume and Issue: 15(4), P. e088092 - e088092

Published: April 1, 2025

Introduction Postoperative delirium (POD) is a frequent complication in elderly surgical patients, leading to increased morbidity and mortality. Previous studies have shown that noise isolation associated with reduced incidence of the intensive care unit (ICU). This trial aims evaluate impact using noise-cancelling headphones on POD patients undergoing hip surgery. Methods analysis In this randomised controlled trial, total 320 will be group or control group, 1:1 ratio stratified by age (65‒80 years >80 years), type surgery (fracture non-fracture) planned ICU admission (yes no). For used throughout anaesthesia postoperative ICU. Patients routinely managed exposed clinical environment. The primary outcome during 0‒7 days after before hospital discharge, assessed 3 min Confusion Assessment Method for Intensive Care Unit. secondary outcomes include pain at 6, 24 48 hours surgery; sleep quality first second nights nausea vomiting within postoperatively; cognitive function mortality 30 Ethics dissemination was approved Committee First Affiliated Hospital Soochow University (Approval No. 2024–054). results submitted peer review publication scientific journal. Trial registration number Chinese Clinical Registry (ChiCTR2400082211).

Language: Английский

Citations

0