Effect of Preoperative Sarcopenia on Postoperative Delirium in Elderly Patients Undergoing Gastrointestinal Surgery

Study Overview
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Brief Summary
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The goal of this observational study is to compare Incidence of postoperative delirium in Sarcopenic and non-sarcopenic elderly patients undergoing gastrointestinal surgery. The main question it aims to answer are: • Effect of preoperative sarcopenia on postoperative delirium in elderly patients undergoing gastrointestinal surgery Participants will be evaluated preoperatively for sarcopenia and assessed for postoperative delirium, pain, etc.

Official Title
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The Second Affiliated Hospital of Nanchang University

Conditions
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Postoperative Delirium, Sarcopenia, Gastrointestinal Surgery, Anesthesia

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥ 65 years old, gender is not limited Patients to undergo elective abdominal surgery (gastrointestinal tumor resection) under general anesthesia, with an expected operation duration of about 2h 4h ASA Ⅰ-Ⅲ Exclusion Criteria: Relative contraindications to general anesthesia: Patients with severe heart and lung disease, severe infection, uncontrolled hypertension, diabetes, and severe diabetic complications Abnormal renal and liver function: AST or ALT≥2.5×ULN, TBIL≥1.5×ULN, Serum creatinine concentration (SCC)≥1.5×ULN People with a history of mental illness or long-term use of psychotropic drugs (dementia, schizophrenia), chronic analgesic drug use, alcoholism, and cognitive impairment Any cardiovascular or cerebrovascular accidents occurred within 3 months, such as myocardial infarction, stroke, transient ischemic attack Myasthenia gravis patients Unable to cooperate to complete the test, the patient or family member rejected the participant

Ages Eligible for Study
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Minimum Age: 65 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 |
| --- | --- |
| Sarcopenia group<br> | |
| Non sarcopenic group<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of postoperative delirium | Postoperative delirium was assessed using the 3D-CAM scale. It consists of 4 features, and a positive feature 1 and 2 plus 3 or 4 is considered postoperative delirium. | Within 7 days after surgery. Delirium at any time during the 7 days after surgery was considered postoperative delirium. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Systolic pressure | just entering the operating room, immediately after intubation, every 5 minutes after intubation until the patient leaves the operating room. | Up to 5 hours in the operating room | 
| Diastolic pressure | just entering the operating room, immediately after intubation, every 5 minutes after intubation until the patient leaves the operating room. | Up to 5 hours in the operating room | 
| Mean pressure | just entering the operating room, immediately after intubation, every 5 minutes after intubation until the patient leaves the operating room. | Up to 5 hours in the operating room | 
| Heart rate | just entering the operating room, immediately after intubation, every 5 minutes after intubation until the patient leaves the operating room. | Up to 5 hours in the operating room | 
| Incidence of postoperative admission to ICU | Including immediate postoperative admission to ICU and postoperative admission to ICU in the ward. | Up to 1 month after surgery | 
| Length of stay in ICU | Duration of stay in ICU after surgery | Up to 1 month after surgery | 
| Postoperative pain | The degree of postoperative pain was assessed using the Numerical Rating Scale (NRS). The pain level increased sequentially from 0-10 | Within 7 days after surgery | 
| Maximum postoperative C-reactive protein (CRP) | Only the highest CRP values detected in the normal course of gastrointestinal surgery are collected, and no additional blood sampling or interventions are performed | Up to 1 month after surgery | 
| Minimum postoperative albumin | Only the lowest albumin values detected in the normal course of gastrointestinal surgery are collected, and no additional blood sampling or interventions are performed | Up to 1 month after surgery | 
| Length of hospitalization | The total number of days the patient spent at the hospital for the current consultation | After the patient is discharged from the hospital, average 1 month | 
| Complication | All the perioperative complications are recorded | During the perioperative period, up to 1 month after surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Postoperative Delirium, Sarcopenia, Gastrointestinal surgery, Anesthesia