Key circRNA Identification of Postoperative Delirium in Elderly Patients Undergoing Cardiac Surgery

Study Overview
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Brief Summary
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The observational study aims to discover differentially expressed circRNAs in the peripheral blood of patients with postoperative delirium, which aims to answer the main questions at: Whether there are changes in circRNA expression in peripheral blood in elderly patients with delirium after cardiopulmonary bypass surgery? Whether the circRNA with altered expression plays an important role in the occurrence and development of POD? What are the functions and underlying mechanisms of circRNA with altered expression in POD? Voluntary patients will receive follow-up 1 day before and 7 days after surgery to assess their cognitive function, and peripheral blood will be collected 1 day before and 3 days after surgery. The study divided patients into POD group and non-POD group according to whether delirium occurred within 7 days after surgery.

Detailed Description
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Investigators combined qRT-PCR by performing circRNAs chip analysis to study differential expression of circRNAs in plasma samples of elderly patients with non-POD who underwent cardiac surgery under general anesthesia and cardiopulmonary bypass. Subsequently, miRNA binding sites and associated mRNAs are predicted by bioinformatics analysis. Moreover, we plan to construct predicted circN-MIRNA-MRNA co-expression networks to study the main functions and pathways of target genes, thereby attempting to provide a preliminary view of the potential role of a circRNA in POD. The study may provide an important perspective on the differential expression of circRNA in patients with POD, and may also provide insights into biomarkers and therapeutic targets of POD.

Official Title
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Key circRNA Identification of Postoperative Delirium in Elderly Patients Undergoing Cardiac Surgery

Conditions
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Postoperative Delirium

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Be over 50 years old; ASA Grade I-III; Heart surgery is planned under general anesthesia. Exclusion Criteria: Patients with the second surgery; The ejection fraction is less than 40%; The score of the preoperative simple mental status examination (MMSE) is less than 24 points; Patients with mental illness or central nervous system disease; Patients who cannot or refuse to complete MMSE before surgery.

Ages Eligible for Study
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Minimum Age: 50 Years
Maximum Age: 90 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 |
| --- | --- |
| POD group<br>According to the occurrence of postoperative delirium, the patients were divided into POD group and non-POD group | |
| non-POD group<br>According to the occurrence of postoperative delirium, the patients were divided into POD group and non-POD group | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Differences in circRNA microarrays before and after surgery | Plasma was isolated from peripheral blood, RNA samples were prepared, and circRNA microarray analysis was performed. The differences in circRNA expression in peripheral blood of POD patients and non-POD patients were comprehensively analyzed. | 1 day before surgery，3 day after surgery | 
| 3-minute Diagnostic Interview for CAM | Postoperative delirium was assessed by 3-minute Diagnostic Interview for confusion assessment method (CAM). | Consecutive 7 days after the surgery |