Ignite Creation Date:
2024-05-06 @ 5:33 PM
Last Modification Date:
2024-10-26 @ 2:30 PM
Study NCT ID:
NCT05341531
Status:
NOT_YET_RECRUITING
Last Update Posted:
2022-04-22
First Post:
2022-03-17
Brief Title:
Relationship Between Perioperative Related Factors and Inflammatory Markers and Postoperative Delirium in Elderly Patients With Non-cardiac Major Surgery
Sponsor:
Beijing Friendship Hospital
Organization:
Beijing Friendship Hospital
Study Overview
Official Title:
Relationship Between Perioperative Related Factors and Inflammatory Markers and Postoperative Delirium in Elderly Patients With Non-cardiac Major Surgery
Status:
NOT_YET_RECRUITING
Status Verified Date:
2022-04
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Perioperative neurocognitive impairment including postoperative delirium POD is common in older patients after anesthesia and surgery and is associated with poorer short- and long-term outcomes including worsening cognitive decline surgical Complications increased risk of hospitalization and death after cardiac and noncardiac surgery POD is more common with age occurs in up to 65 of elderly patients and increases in patients with mild cognitive impairment As more and more older adults undergo surgery and anesthesia POD has become a major global health challenge requiring urgent attention Prevention strategies involving multidisciplinary perioperative interventions may have some benefit overall but the impact on POD remains uncertain Known inflammatory responses may be associated with adverse outcomes such as neurocognitive dysfunction and cancer recurrence after major surgery Different anesthesia methods the regulation of anesthesia drugs on postoperative inflammatory response has been confirmed in vitro but its clinical significance is still unclear Therefore exploring the risk factors of inducing POD has important clinical significance for the early prevention of POD Second a recent study found that the incidence of POD was significantly higher in patients whose sleep cycle was disturbed during hospitalization Animal experiments found that after 5 hours of sleep deprivation in adult mice the number of dendritic spines in CA1 neurons in the hippocampus was reduced and the length of dendrites was significantly shortened which damaged the synaptic transmission of the central nervous system and significantly improved memory and cognitive function Damaged And many studies have investigated whether bispectral index BIS-guided anesthesia is associated with a reduced risk of POD compared with standard-of-care anesthesia or the use of goal-directed end-tidal volatile agent concentrations the reasoning is that the use of BIS-guided anesthesia results in less anesthesia exposure and therefore light anesthesia may reduce the incidence of postoperative POD compared to deep anesthesia However this conclusion is still controversial The study of Anshentong et al has confirmed that deep anesthesia with BIS maintained at 40-49 can delay postoperative recovery time reduce the level of inflammatory factors and the incidence of early postoperative cognitive impairment and reduce the incidence of early postoperative cognitive impairment Brain damage Therefore although age is known to be the main correlative factor for POD different depths of anesthesia may cause different stress responses in patients resulting in different release of inflammatory factors An additional risk factor may be preoperative psychiatric symptoms and assessment of mental status is often overshadowed by concerns about multiple comorbidities in older adults Anxiety disorders are one of the prominent psychiatric symptoms in older adults very common Preoperative anxiety is defined as an unpleasant restless or tense state secondary to patient concerns about illness hospitalization anesthesia surgery or the unknown Studies on the relationship between preoperative anxiety and POD also vary in consistency due to the characteristics of different populations Many of the current studies are mostly single-center with limited sample size which may have a certain bias in the conclusions Therefore the investigators designed and planned to conduct a multi-center large-sample cohort study to determine the impact of perioperative related factors and inflammatory markers on elderly patients undergoing non-cardiac major surgery
Detailed Description:
None
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None