Association between preoperative cardiometabolic multimorbidity and postoperative delirium in elderly patients undergoing knee or hip replacement
10.3760/cma.j.cn131073-20241227-01009
- VernacularTitle:膝或髋关节置换术老年患者POD与术前CMM的关系
- Author:
Kun WANG
1
;
Na TIAN
;
Yuanlong WANG
;
Wenjie KONG
;
Yizhi LIANG
;
Jiahan WANG
;
Yanan LIN
;
Chuan LI
;
Hongyan GONG
;
Xu LIN
;
Bin WANG
;
Yanlin BI
Author Information
1. 山东第二医科大学麻醉学院，潍坊 261053
- Publication Type:Journal Article
- Keywords:
Aged;
Delirium;
Cardiovascular Diseases;
Metabolic Diseases;
Comorbidity
- From:
Chinese Journal of Anesthesiology
2025;45(10):1275-1279
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the association between preoperative cardiometabolic multimorbidity (CMM) and postoperative delirium (POD) in elderly patients undergoing knee or hip replacement.Methods:Based on a perioperative neurocognitive dysfunction and biomarker lifestyle cohort, a nested case-control study was conducted using medical records of patients scheduled for elective knee or hip joint replacement at Qingdao Municipal Hospital from January 2022 to November 2023. Patients were divided into POD group ( n=124) and non-POD group ( n=414) based on whether POD occurred. The influencing factors were collected, and intergroup differences were analyzed. Logistic regression was used to identify the risk factors for POD, and sensitivity analysis was conducted to assess the stability of the regression model. A mediation model was employed to examine whether cerebrospinal fluid (CSF) biomarkers mediated the association between CMM and POD. Results:There were statistically significant differences in the rate of CMM, age, years of education, rate of hypertension, rate of diabetes mellitus, rate of coronary heart diseases, rate of stroke, Aβ 42 concentration, t-tau concentration, p-tau concentration, Aβ 42/t-tau ratio, and Aβ 42/p-tau ratio in CSF between POD group and non-POD group ( P<0.05). The results of logistic regression analysis showed that preoperative CMM was a risk factor for POD ( P<0.05). Mediation analysis revealed that the relationship between CMM and POD was partly mediated by Aβ 42 concentrations in CSF. Conclusions:Preoperative CMM is a risk factor for POD in elderly patients undergoing knee or hip replacement, and the CSF Aβ 42 concentration may play a partly mediating role in the association between preoperative CMM and POD.
