This study is a retrospective analysis of a large-scale multicentre prospective cohort study that investigates the impact of preoperative depression on the incidence of postoperative delirium among elderly Chinese patients undergoing non-cardiac major surgery.
Preoperative depression is common among elderly surgical patients and may adversely affect postoperative outcomes. However, there is limited research on the relationship between preoperative depression and postoperative delirium (POD) in elderly patients undergoing non-cardiac major surgery. This study retrospectively analysed data from a prospective database (PDCEP) of patients aged 65 and above who underwent non-cardiac major elective surgery in multiple tertiary hospitals across 10 provinces in China. The study period spanned from April 1, 2020 to April 30, 2022. Preoperative depression was assessed using the Patient Health Questionnaire-9 (PHQ-9), with PHQ-9 \> 5 defined as the depression group and PHQ-9 \< 5 as the non-depression group. Postoperative delirium was evaluated using the 3-minute Diagnostic Interview for CAM (3D-CAM). Binary logistic regression analyses were conducted, and propensity score-matching (PSM) and subgroup analyses were also applied.
Study Type
OBSERVATIONAL
Enrollment
8,000
Postoperative Delirium
Postoperative delirium (POD) incidence was assessed using the 3-minute Diagnostic Interview for CAM (3D-CAM). The 3D-CAM is a validated tool for the detection of delirium in older adults. It evaluates four key features: acute onset and fluctuating course, inattention, disorganized thinking, and altered level of consciousness. If the patient was discharged, follow-up was conducted by telephone or email.
Time frame: Delirium within 7 days of surgery
Postoperative Acute Pain
Postoperative acute pain was assessed using the Numerical Rating Scale (NRS). The NRS is an 11-point scale ranging from 0 (no pain) to 10 (worst possible pain).
Time frame: Pain within 7 days of surgery
Postoperative Pulmonary Infection
Postoperative pulmonary infection was assessed through physical examination and laboratory tests (chest X-ray, white blood cell count, etc.).
Time frame: Within 7 days of surgery
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