CLINICAL TRIAL article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1581503
This article is part of the Research TopicMechanisms and Interventions for Post-Operative Neurocognitive Disorder and Sleep DisruptionsView all 16 articles
Association Between Educational Level and Postoperative Delirium in Older Patients Undergoing Abdominal Surgery: A Two-Sample Cohort Study
Provisionally accepted
- Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
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Background: Postoperative delirium (POD) is a critical complication in older elderly patients following abdominal surgery, significantly contributing to delayed recovery and prolonged hospital stays. Understanding the risk factors associated with POD is essential for developing effective prevention and intervention strategies. This study investigates the potential impact of educational attainment on the incidence of delirium in this patient population.Methods: This study utilized a two-sample cohort design to collect demographic and educational attainment, and clinical data, including, from older elderly patients undergoing abdominal surgery. The assessment of delirium during the recovery phase was conducted using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and the 3-Minute Diagnostic Interview for Confusion Assessment Method within the first three postoperative days. In the exploratory cohort, the relationship between education and postoperative delirium was determined by univariate analysis, followed by multivariate logistic regression to determine that education was an independent predictor. The identified risk factors were subsequently validated in an independent validation cohort to ensure robustness and generalizability.The exploratory cohort consisted of 342 cases, while the validation cohort included 150 cases. Exploratory cohort regression analysis identified lower educational attainment and procedures or anesthesia lasting longer than 4 hours as independent risk factors for POD. Anesthesia time of more than 4 hours was also an independent risk factor for delirium during resuscitation.Lower educational attainment is significantly related to an increased chance of POD in older adults undergoing abdominal procedures. These findings suggest that preoperative assessments should incorporate educational level as a potential risk factor, providing a basis for targeted prevention and intervention strategies to mitigate POD.
Keywords: older patients1, postoperative delirium2, Abdominal surgery3, Risk Factors4, cognitive reserve5
Received: 22 Feb 2025; Accepted: 30 Apr 2025.
Copyright: © 2025 Xiang, Liu, Wang, Li, Fan and Tang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jia Tang, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
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