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.
Study Type
OBSERVATIONAL
Enrollment
400
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.
Department of Anesthesia of the Affiliated Hospital of Xuzhou Medical University
Xuzhou, Jiangsu, China
RECRUITINGConfusion Assessment Method（CAM)
Confusion Assessment Method to measure delirium
Time frame: before discharge from PACU
Confusion Assessment Method（CAM)
Confusion Assessment Method to measure delirium
Time frame: morning of the 1st day after surgery
Confusion Assessment Method（CAM)
Confusion Assessment Method to measure delirium
Time frame: afternoon of the 1st day after surgery
Confusion Assessment Method（CAM)
Confusion Assessment Method to measure delirium
Time frame: morning of the 2st day after surgery
Confusion Assessment Method（CAM)
Confusion Assessment Method to measure delirium
Time frame: afternoon of the 2st day after surgery
Confusion Assessment Method（CAM)
Confusion Assessment Method to measure delirium
Time frame: morning of the 3st day after surgery
Confusion Assessment Method（CAM)
Confusion Assessment Method to measure delirium
Time frame: afternoon of the 3st day after surgery
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).
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Time frame: 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).
Time frame: 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.
Time frame: 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.
Time frame: 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.
Time frame: 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.
Time frame: 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.
Time frame: 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.
Time frame: 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.
Time frame: afternoon of the 3st day after surgery
Mini-Mental score examination (MMSE)
Mini-Mental score examination \[MMSE\] used for screening of dementia
Time frame: 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
Time frame: 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
Time frame: one month after surgery
serum folic acid levels
Record preoperative serum folic acid levels
Time frame: 1 day before surgery(baseline)
serum vitamin B12 levels
Record preoperative serum vitamin B12 levels
Time frame: 1 day before surgery(baseline)
serum homocysteine content
Record preoperative serum homocysteine content
Time frame: 1 day before surgery(baseline)
serum branched chain amino acid content
Record preoperative serum branched chain amino acid content
Time frame: 1 day before surgery(baseline)