Postoperative cognitive impairment (POCD) is a common complication of anesthesia and surgery, characterized by a decline in various cognitive functions such as memory, attention, and information processing speed, which can last for several months
Conditions
Interventions
Neoadjuvant immunotherapy group:None
Neoadjuvant chemotherapy or direct surgery group:None
Sponsors
West China Hospital of Sichuan University
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Age >=18 years. 2. Histologically or cytologically confirmed primary non-small cell lung cancer (NSCLC), with clinical stage resectable I-III (according to the latest TNM staging), and planned for elective video-assisted thoracoscopic radical resection of lung cancer. 3. Preoperative treatment pathway meets one of the following: A) surgery after neoadjuvant ICI +/- chemotherapy; B) surgery after neoadjuvant chemotherapy; C) direct surgery. 4. ASA grade I-III. 5. Signed informed consent.
Exclusion criteria
Exclusion criteria: 1. There is a clear history of moderate to severe cognitive impairment (such as dementia, Alzheimer's disease) or severe mental illness before surgery; 2. There are severe visual, hearing, or physical impairments that prevent the completion of neuropsychological tests; 3. History of central nervous system metastasis, stroke, and severe traumatic brain injury; 4. Active autoimmune diseases or long-term use of immunosuppressants/corticosteroids: Continuous use of systemic corticosteroids>10 mg prednisone equivalent/day for the past 30 days and>14 days, or use of other immunosuppressants; 5. Preoperative presence of acute delirium, severe depression/anxiety attacks, or uncorrected severe metabolic/endocrine abnormalities (such as severe thyroid dysfunction, severe electrolyte imbalance); 6. With existing cognitive impairment, manifested by preoperative Mini Mental State Examination (MMSE) scores: scores<17 for those with education for 0-4 years, <20 for those with education for 5-8 years, and <24 for those over 9 years.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Incidence of Postoperative Cognitive Dysfunction (POCD) on Day 1 after surgery; | — |
Secondary
| Measure | Time frame |
|---|---|
| Incidence of Postoperative Cognitive Dysfunction (POCD) on Day 7 and Day 30 after surgery;Visual Analog Scale (VAS) for Pain in Resting State;Duration of One-Lung Ventilation, Surgical Duration, and Anesthesia Duration;Changes in Neutrophil Count and Lymphocyte-to-Monocyte Ratio (LMR) from Preoperative to Postoperative Day 1;Hospital Length of Stay and Hospitalization Costs; | — |
Countries
China
Contacts
Public ContactLi Xuehan
West China Hospital of Sichuan University
Outcome results
None listed