Role of Metabolic Syndromes (MetS) in the Incidence of Post-Operative Delirium and Cognitive Dysfunction in Elderly Patients Undergoing Major Surgery under General Anaesthesia: A Prospective Observational Study
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 100
- 试验地点
- 1
- 主要终点
- We anticipate to be able to justify the risk of postoperative delirium and postoperative cognitive dysfunction due to the metabolic syndrome.
研究概览
简要总结
This prospective observational study aims to investigate the association between Metabolic Syndrome (MetS)and the incidence of Post-Operative Delirium (POD) and Post-Operative Cognitive Dysfunction (POCD) in elderly patients (equal or greater than 60 years) undergoing major surgery under general anesthesia. POD and POCD are common neurocognitive complications in older adults after surgery and are associated with increased morbidity, mortality, and extended hospital stays (1). Although factors such as neuroinflammation and neurotransmitter imbalance have been linked to these conditions, the role of metabolic abnormalities remains inadequately explored (2). Metabolic Syndrome (MetS), characterized by hypertension, high blood sugar, elevated triglycerides, low HDL cholesterol, and central obesity, is widespread among the elderly and associated with cognitive decline (3). In this study, 100 patients will be evaluated for metabolic markers and undergo cognitive testing using DRS-R-98, Trail Making Test, and ACE-III both before and after surgery. The objective is to determine if Metabolic Syndrome (MetS) is a significant predictor of POD and POCD. If a strong correlation is found, Metabolic Syndrome (MetS) could be considered a modifiable risk factor, enabling targeted preoperative interventions (4). This may lead to improved perioperative risk assessment, better patient outcomes, and reduced healthcare burden. Ultimately, the study’s findings could contribute to developing preventive strategies for cognitive decline in elderly surgical patients.
References:
Vasilevskis EE, Han JH, Hughes CG, Ely EW. Epidemiology and risk factors for delirium across hospital settings. Best Pract Res Clin Anaesthesiol. 2012 Sep;26(3):277– 87.
Feinkohl I, Janke J, Hadzidiakos D, et al. Associations of the metabolic syndrome and its components with cognitive impairment in older adults. BMC Geriatr 2019; 19: 77
Strachan MWJ, Reynolds RM, Frier BM, Mitchell RJ, Price JF. The relationship between type 2 diabetes and dementia. Br Med Bull 2008; 88: 131e46
Gregory, S. H., King, C. R., Abdallah, A. B., Kronzer, A., & Wildes, T. S. (2021). Abnormal preoperative cognitive screening in aged surgical patients: a retrospective cohort analysis. British journal of anaesthesia, 126(1), 230-237.
研究设计
- 研究类型
- Observational
入排标准
- 年龄范围
- 60.00 Year(s) 至 99.00 Year(s)（—）
- 性别
- All
入选标准
- •1.Patients age above 60 years.
- •2.Undergoing major surgery under general anaesthesia.
- •3.ASA I and ASA II.
- •4.There is no minimum cognitive performance required to participate 5.Ability to give informed consent.
排除标准
- •1.Patients with a history suggestive of psychiatric disease like schizophrenia, dementia, and anxiety or other neurological disorder affecting cognition, mental dysfunction.
- •2.History of cerebral surgeries, stroke.
- •3.Prescription of central nervous system–active medication (e.g.antidepressants, antipsychotics, sedatives).
结局指标
主要结局
We anticipate to be able to justify the risk of postoperative delirium and postoperative cognitive dysfunction due to the metabolic syndrome.
时间窗: The outcome will be assessed at four different | time points: 24 hours before surgery (baseline), 24 hours after surgery, | and 8 weeks after surgery
次要结局
未报告次要终点
研究者
Dr Puneet Khanna
All India Institute of Medical Science (AIIMS), New Delhi.