Postoperative Delirium Clinical Trial
Official title:
Correlation Analysis of Postoperative Delirium and Postoperative Neurocognitive Disorder in Elderly Patients With Gastrointestinal Neoplasms Based on Resting State Functional Magnetic Resonance Imaging
This is a prospective cohort study to explore the differences of resting-state functional magnetic resonance imaging (fMRI) between elderly gastrointestinal neoplasms patients with postoperative delirium (POD) who either develop or do not develop long-term postoperative neurocognitive disorders (pNCD).
The purpose of this study is to explore the differences of resting-state functional magnetic resonance imaging (fMRI) between elderly gastrointestinal neoplasms patients with postoperative delirium (POD) who either develop or do not develop long-term postoperative neurocognitive disorders (pNCD). Elderly gastrointestinal neoplasms patients aged 65 and above, undergoing surgical operations at Xuanwu Hospital, Capital Medical University, were selected. All patients underwent baseline fMRI scan before surgery, and their neurocognitive function was assessed using the Montreal Cognitive Assessment (MoCA) within 1 week before surgery. General patient data such as sex, age, comorbidities, BMI, ASA classification, and MoCA scores were collected. Under routine anesthetic management of the Department of Anesthesiology and Surgical Operations at Xuanwu Hospital, endotracheal intubation general anesthesia was performed. Intraoperative monitoring included heart rate, blood pressure, pulse oximetry, and body temperature, with surgery and anesthesia times, and fluid balance recorded. Within 7 days post-surgery, delirium assessment was conducted using the Confusion Assessment Method (CAM), classifying patients into POD and non-POD groups.For the patients in the POD group, neurocognitive function was assessed at a period of time after surgery to determine the presence of pNCD, further dividing the POD group into pNCD and non-pNCD subgroups, followed by fMRI scanning. Differences of FC in fMRI were compared between patients with POD who did or did not develop postoperative neurocognitive dysfunction. By comparing the patterns and intensities of brain functional connectivity between the pNCD and non-pNCD subgroups, a differential analysis was conducted on the effective connectivity and information flow of functional networks, exploring the state of the brain functional network during the process of POD and pNCD. ;
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