Predisposing and precipitating factors for perioperative delirium for the elderly remain elusive. This research will be conducted to determine risk factors of postoperative delirium.
65 to 90 years old to receive elective major abdominal surgery (expected operation time over 2 hours); ,
American society of Aneshesiologists（ASA）physical status I-III;
Mini-Mental State Examination (MMES) score < 15;
Renal failure (requiring dialysis) or liver failure (Child-Pugh score > 5);
Severe impairment due to structural or hypoxic brain injury, more than 2 days in ICU one month before surgery;
Underwent major heart, lung or abdominal surgery within 1 year;
Patients aged 65 to 90 years who received elective major abdominal surgery (estimated operation time over 2 hours)
Cohort
Prospective
Not listed
Incidence of delirium during first 7 days after surgery
The result of 3-minute Diagnostic Interview for Confusion Assessment Method (3D-CAM) is positive.
Preoperative cognitive function
The Mini-Mental State Examination scale will be used to assist in evaluating preoperative cognitive function in patients. The scale's testing items include orientation, memory, calculation, language, visual space, use, and attention, with a total score of 30. The higher the score, the better the cognitive function, and the score below 27 indicates possible cognitive impairment.
Age-adjusted Charlson Comorbidity Index
Age-adjusted Charlson Comorbidity Index is a method used to evaluate the impact of multiple diseases on a patient's health status. The scale includes a total of 16 common co-morbidity diseases, which is divided into 4 categories according to different disease severity, with scores of 1,2,3 or 6. The higher the score, the more kinds of diseases the patient suffers at the same time, and their health status may be more complex and fragile.
Preoperative anxiety
Hamilton Anxiety Scale will be used to evaluate the patient's anxiety status, which consist of 14 items. All items are scored on a 5-level scale of 0-4, with criteria for each level being none, mild, moderate, severe, and extremely severe. The higher the score, the more severe the anxiety symptoms.
Serum biomakers levels
Extract venous blood samples from the target patient, store and centrifuge the Samples appropriately. Quantitatively detect the serum biomakers levels, such as NFL, using enzyme-linked immunosorbent assay, and retest the concentration changes of these biomarkers 3 days after surgery.
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