Delirium, Postoperative Cognitive Dysfunction
Conditions
Keywords
Postoperative Cognitive Dysfunction, Delirium, UACR
Brief summary
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.
Interventions
DIAGNOSTIC_TESTNeuropsychological tests
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.
Sponsors
Han Yuan
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Non-cardiac surgery patients; * Age is greater than or equal to 60 years old; ③Han Nationality, mother tongue is chinese; ④The MMSE score:Illiteracy is greater than or equal to 17 points, primary school is greater than or equal to 20 points, higher secondary school is more than 24 points; ⑤The people signed informed consent.
Exclusion criteria
* The diagnosis of preoperative delirium； * The diagnosis Unstable hypertension（Such as：pheochromocytoma or aortic dissection）； ③Severe chronic obstructive pulmonary disease or congestive heart failure； ④Severe liver and kidney dysfunction;
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Confusion Assessment Method（CAM) | before discharge from PACU | Confusion Assessment Method to measure delirium |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| serum homocysteine content | 1 day before surgery(baseline) | Record preoperative serum homocysteine content |
| serum branched chain amino acid content | 1 day before surgery(baseline) | Record preoperative serum branched chain amino acid content |
| Quality of Recovery Score - 40 (QoR-40) | 1 day before surgery(baseline) | 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). |
| Numerical Rating Scale（NRS） | before discharge from PACU | Evaluate the severity using numerical rating scale（NRS）, where zero mean no pain and 10 the worst imaginable pain. |
| Mini-Mental score examination (MMSE) | 1 day before surgery(baseline) | Mini-Mental score examination \[MMSE\] used for screening of dementia |
| Mini-Mental score examination (MMSE) and Neuropsychological tests | 6±1 days after surgery | Mini-Mental score examination (MMSE) and Neuropsychological tests to measure cognitive function, including the Trail |
| serum folic acid levels | 1 day before surgery(baseline) | Record preoperative serum folic acid levels |
| serum vitamin B12 levels | 1 day before surgery(baseline) | Record preoperative serum vitamin B12 levels |
Other
| Measure | Time frame | Description |
|---|---|---|
| blood Albumin levels | before surgery(baseline) | Record preoperative blood Albumin levels |
| blood Hemoglobin content | before surgery(baseline) | Record preoperative blood Hemoglobin content |
| blood Alanine aminotransferase （ALT） levels | before surgery(baseline) | Record preoperative blood Alanine aminotransferase （ALT） levels |
| blood Aspartate aminotransferase （AST）levels | before surgery(baseline) | Record preoperative blood Aspartate aminotransferase （AST）levels |
| Blood urea nitrogen（BUN） levels | before surgery(baseline) | Record preoperative Blood urea nitrogen（BUN） levels |
| Blood creatinine（Cr） levels | before surgery(baseline) | Record preoperative Blood creatinine（Cr） levels |
Countries
China
Contacts
Primary ContactJunli Cao
Backup ContactYuan Han
Outcome results
None listed