Correlation Between Urine UACR and Postoperative Neurocognitive Disorder in Elderly Patients With Non-cardiac Surgery

Study Overview
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Brief Summary
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This study intends to evaluate the relationship between urinary albumin/creatinine ratio and postoperative neurocognitive impairment in elderly non-cardiac surgery patients. The results of the study are to identify risk factors, screen high-risk populations to improve clinical evidence, early detection and early treatment.And reducing the burden of PNCD on patients and their families, hospitals and public resources.

Official Title
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Correlation Between Urine UACR and Postoperative Neurocognitive Disorder in Elderly Patients With Non-cardiac Surgery

Conditions
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Postoperative Cognitive Dysfunction, Delirium

Intervention / Treatment
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* Diagnostic Test: Neuropsychological tests


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Non-cardiac surgery patients; Age is greater than or equal to 60 years old; ③Han Nationality, mother tongue is chinese; ④The MMSE score:Illiteracy is greater than or equal to 17 points, primary school is greater than or equal to 20 points, higher secondary school is more than 24 points; ⑤The people signed informed consent. Exclusion Criteria: The diagnosis of preoperative delirium； The diagnosis Unstable hypertension（Such as：pheochromocytoma or aortic dissection）； ③Severe chronic obstructive pulmonary disease or congestive heart failure； ④Severe liver and kidney dysfunction;

Ages Eligible for Study
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Minimum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| study group<br>400 Male and female patients undergoing non-cardiac surgery at the Affiliated Hospital of Xuzhou Medical University [Jiangsu China].We do the neuropsychological tests,MMSE,CCI，CDR,QoR-40,GDS,CAGE Alcoholism Questionnaire，Pure Tone Audiometry，blood albumin、hemoglobin content、ALT、AST、BUN、Cr、serum folic acid、vitamin B12、homocysteine and branched chain amino acid content 1 day before the surgery（baseline）； 1 day before the surgery（baseline）； Confusion Assessment Method（CAM)，NRS once before discharge from PACU and 1、2、3 days after surgery twice a day； QoR-40 1 day after surgery； Neuropsychological tests and MMSE 6±1 days and one month after surgery. | Diagnostic Test: Neuropsychological tests<br>* We do the neuropsychological tests, Mini-Mental score examination (MMSE),Charlson Comorbidity Index(CCI)，Clinical Dementia Rating(CDR),Quality of Recovery Score - 40 (QoR-40),Geriatric Depression Scale (GDS),CAGE Alcoholism Questionnaire，Pure Tone Audiometry，blood albumin、hemoglobin content、ALT、AST、BUN、Cr、serum folic acid、vitamin B12、homocysteine and branched chain amino acid content 1 day before the surgery（baseline）； 1 day before the surgery（baseline）； Confusion Assessment Method（CAM)，Numerical Rating Scale（NRS）once before discharge from PACU and 1、2、3 days after surgery twice a day； QoR-40 1 day after surgery； Neuropsychological tests and MMSE 6±1 days and one month after surgery.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Confusion Assessment Method（CAM) | Confusion Assessment Method to measure delirium | before discharge from PACU | 
| Confusion Assessment Method（CAM) | Confusion Assessment Method to measure delirium | morning of the 1st day after surgery | 
| Confusion Assessment Method（CAM) | Confusion Assessment Method to measure delirium | afternoon of the 1st day after surgery | 
| Confusion Assessment Method（CAM) | Confusion Assessment Method to measure delirium | morning of the 2st day after surgery | 
| Confusion Assessment Method（CAM) | Confusion Assessment Method to measure delirium | afternoon of the 2st day after surgery | 
| Confusion Assessment Method（CAM) | Confusion Assessment Method to measure delirium | morning of the 3st day after surgery | 
| Confusion Assessment Method（CAM) | Confusion Assessment Method to measure delirium | afternoon of the 3st day after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quality of Recovery Score - 40 (QoR-40) | Quality of recovery will be evaluated by Quality of Recovery 40 (QoR40),which assesses five dimensions of recovery (physical comfort,emotional state, physical independence , physiological support and pain ). Each item is rated on a five-point Likert scale: none of the time, some of the time, usually, most of the time, and all the time. The total score on the QoR40 ranges from 40 (poorest quality of recovery) to 200 (best quality of recovery). | 1 day before surgery(baseline) | 
| Quality of Recovery Score - 40 (QoR-40) | Quality of recovery will be evaluated by Quality of Recovery 40 (QoR40),which assesses five dimensions of recovery (physical comfort,emotional state, physical independence , physiological support and pain ). Each item is rated on a five-point Likert scale: none of the time, some of the time, usually, most of the time, and all the time. The total score on the QoR40 ranges from 40 (poorest quality of recovery) to 200 (best quality of recovery). | 1 day after surgery | 
| Numerical Rating Scale（NRS） | Evaluate the severity using numerical rating scale（NRS）, where zero mean no pain and 10 the worst imaginable pain. | before discharge from PACU | 
| Numerical Rating Scale（NRS） | Evaluate the severity using numerical rating scale（NRS）, where zero mean no pain and 10 the worst imaginable pain. | morning of the 1st day after surgery | 
| Numerical Rating Scale（NRS） | Evaluate the severity using numerical rating scale（NRS）, where zero mean no pain and 10 the worst imaginable pain. | afternoon of the 1st day after surgery | 
| Numerical Rating Scale（NRS） | Evaluate the severity using numerical rating scale（NRS）, where zero mean no pain and 10 the worst imaginable pain. | morning of the 2st day after surgery | 
| Numerical Rating Scale（NRS） | Evaluate the severity using numerical rating scale（NRS）, where zero mean no pain and 10 the worst imaginable pain. | afternoon of the 2st day after surgery | 
| Numerical Rating Scale（NRS） | Evaluate the severity using numerical rating scale（NRS）, where zero mean no pain and 10 the worst imaginable pain. | morning of the 3st day after surgery | 
| Numerical Rating Scale（NRS） | Evaluate the severity using numerical rating scale（NRS）, where zero mean no pain and 10 the worst imaginable pain. | afternoon of the 3st day after surgery | 
| Mini-Mental score examination (MMSE) | Mini-Mental score examination [MMSE] used for screening of dementia | 1 day before surgery(baseline) | 
| Mini-Mental score examination (MMSE) and Neuropsychological tests | Mini-Mental score examination (MMSE) and Neuropsychological tests to measure cognitive function, including the Trail | 6±1 days after surgery | 
| Mini-Mental score examination (MMSE) and Neuropsychological tests | Mini-Mental score examination (MMSE) and Neuropsychological tests to measure cognitive function, including the Trail | one month after surgery | 
| serum folic acid levels | Record preoperative serum folic acid levels | 1 day before surgery(baseline) | 
| serum vitamin B12 levels | Record preoperative serum vitamin B12 levels | 1 day before surgery(baseline) | 
| serum homocysteine content | Record preoperative serum homocysteine content | 1 day before surgery(baseline) | 
| serum branched chain amino acid content | Record preoperative serum branched chain amino acid content | 1 day before surgery(baseline) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Postoperative Cognitive Dysfunction, Delirium, UACR