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A Mouse Model of Orthopedic Surgery to Study Postoperative Cognitive Dysfunction and Tissue Regeneration
Published on: February 27, 2018
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Insulin Resistance Predicts Postoperative Cognitive Dysfunction in Elderly Gastrointestinal Patients
Xi He1, Ge Long1, Chengxuan Quan1
1Department of Anesthesia, The Third Xiangya Hospital of Central South University, Changsha, China.
Frontiers in Aging Neuroscience
|August 24, 2019
Summary
Preoperative insulin resistance, measured by HOMA-IR, effectively predicts postoperative cognitive dysfunction (POCD) in older surgical patients. Early identification and intervention for insulin resistance may help prevent POCD.
Area of Science:
- Geriatric Medicine
- Anesthesiology
- Metabolic Disorders
Background:
- Aging individuals undergoing surgery face a risk of postoperative cognitive dysfunction (POCD).
- Identifying reliable early predictors for POCD is crucial for patient management.
- This study investigated preoperative insulin resistance as a potential independent predictor of POCD.
Purpose of the Study:
- To determine if preoperative insulin resistance predicts the occurrence of postoperative cognitive dysfunction (POCD).
Main Methods:
- 124 patients (≥60 years) undergoing gastrointestinal surgery were prospectively observed.
- Neuropsychological tests were administered preoperatively and 7 days postoperatively.
- Insulin resistance was assessed using Homeostasis Model Assessment-Insulin Resistance (HOMA-IR); POCD was defined as a ≥1.5 SD decline in two or more tests.
Main Results:
- 41.1% of patients developed POCD.
- Higher preoperative HOMA-IR values were observed in the POCD group.
- Preoperative HOMA-IR was an independent predictor of POCD (adjusted OR 1.88), with HOMA-IR > 2.6 indicating a 3.26-fold increased risk.
- ROC analysis showed HOMA-IR had an area of 0.804 (P < 0.001), with optimal cut-off 0.583 (84.3% sensitivity, 74% specificity).
Conclusions:
- Preoperative insulin resistance is a significant predictor of POCD.
- Targeted interventions for insulin resistance may help prevent POCD in at-risk surgical patients.
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