Preoperative Depression and Postoperative Delirium in Older Chinese Adults: A Multicenter Retrospective Cohort Study
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 8,000
- 主要终点
- Postoperative Delirium
研究概览
简要总结
This study is a retrospective analysis of a large-scale multicentre prospective cohort study that investigates the impact of preoperative depression on the incidence of postoperative delirium among elderly Chinese patients undergoing non-cardiac major surgery.
详细描述
Preoperative depression is common among elderly surgical patients and may adversely affect postoperative outcomes. However, there is limited research on the relationship between preoperative depression and postoperative delirium (POD) in elderly patients undergoing non-cardiac major surgery. This study retrospectively analysed data from a prospective database (PDCEP) of patients aged 65 and above who underwent non-cardiac major elective surgery in multiple tertiary hospitals across 10 provinces in China. The study period spanned from April 1, 2020 to April 30, 2022.
Preoperative depression was assessed using the Patient Health Questionnaire-9 (PHQ-9), with PHQ-9 > 5 defined as the depression group and PHQ-9 < 5 as the non-depression group. Postoperative delirium was evaluated using the 3-minute Diagnostic Interview for CAM (3D-CAM). Binary logistic regression analyses were conducted, and propensity score-matching (PSM) and subgroup analyses were also applied.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 65 Years 至 100 Years（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •1. Age ≥ 65 years, both genders
- •Elective non-cardiac major surgery
- •Completed preoperative depression assessment (PHQ-9)
- •Completed postoperative delirium assessment (3D-CAM)
排除标准
- •1. History of neurological or psychiatric disorders or use of neuropsychiatric medications
- •Impaired cognitive function or inability to complete preoperative follow-up
- •Transferred to ICU postoperatively
- •Missing delirium outcome data
结局指标
主要结局
Postoperative Delirium
时间窗: Delirium within 7 days of surgery
Postoperative delirium (POD) incidence was assessed using the 3-minute Diagnostic Interview for CAM (3D-CAM). The 3D-CAM is a validated tool for the detection of delirium in older adults. It evaluates four key features: acute onset and fluctuating course, inattention, disorganized thinking, and altered level of consciousness. If the patient was discharged, follow-up was conducted by telephone or email.
次要结局
- Postoperative Acute Pain(Pain within 7 days of surgery)
- Postoperative Pulmonary Infection(Within 7 days of surgery)
研究者
Weidong Mi
Associate Chief Physician
Chinese PLA General Hospital