Postoperative delirium is a common complication that frequently occurs in elderly patients after surgery. It not only increases the length of hospital stays and healthcare costs but also raises the incidence of postoperative cognitive dysfunction and even mortality. However, the underlying mechanisms of its onset are not yet fully understood. Evidence suggests that smoking can lead to gut microbiota dysbiosis and metabolic dysfunction, and the gut microbiota and its metabolites play a crucial role in cognitive function through the gut-brain axis. Yet, no studies have reported whether smoking could affect the occurrence of postoperative delirium and the quality of postoperative recovery through the gut microbiota. This study aims to observe the incidence of postoperative delirium and the postoperative recovery quality scores between smokers and non-smokers.
Age >60 years;
American Society of Anesthesiologists (ASA) preoperative anesthesia classification ASA Grades I and II;
Undergoing elective surgery;
Patients and their families are able to understand and complete various scoring scales and voluntarily sign informed consent.
Mini-Mental State Examination (MMSE) score <23;
Preoperative biochemical tests indicate renal dysfunction or active liver disease;
History of definite neurological or psychiatric disorders or history of taking corresponding medications before surgery;
History of alcohol abuse or drug dependency;
Elderly patients who meet the inclusion criteria are divided into a smoking group and a non-smoking group based on their smoking status. The general information of the patients, perioperative data, and postoperative follow-up data are recorded. By conducting propensity score matching analysis, differences in outcomes due to confounding factors are minimized, and exploratory analysis is performed on the matched patient data to investigate the impact of gut microbiota and metabolism on the incidence of postoperative delirium and the quality of postoperative recovery.
Cohort
Prospective
none intervention
Other interventionNo interventions are administered to either group of patients.
Postoperative delirium
CAM method
Quality of recovery in the first postoperative day
Quality of recovery is assessed with the Quality of Recovery-15 questionaire in the first postoperative day.
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