Related Experiment Video
Updated: Apr 8, 2026
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Association between preoperative physical exercise and postoperative delirium in silent brain infarction: A
Hengjun Wan1, Denghui Huang, Yuhang Gao
1From the Department of Anaesthesiology, The Affiliated Hospital (HW, DH, YG, XD), Anaesthesiology and Critical Care Medicine Key Laboratory of Luzhou, Southwest Medical University, Luzhou, Sichuan Province, China (HW, DH, YG, XD), Operating room, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan Province, China (DH), Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany (AK, MC), Department of Anaesthesiology, the People's Hospital of Jianyang, Jianyang (QZ), Department of Anaesthesiology, Zigong First People's Hospital (QL, XL), Department of Anaesthesiology, DaZhou Central Hospital, Dazhou, Sichuan Province, China (XH).
Background:
Evidence is lacking regarding the association between preoperative leisure-time physical activity and postoperative delirium occurrence in high-risk populations with concomitant silent brain infarction.
Objective:
This study aimed to use causal inference models to explore the potential association between leisure-time physical activity before surgery and postoperative delirium occurrence.
Design:
Multicentre prospective cohort study.
Settings:
Four tertiary care medical centres in China from March 2024 to February 2025.
Participants:
This study enrolled 2512 adult patients with asymptomatic cerebral infarction between 2024 and 2025 who were scheduled to undergo elective noncardiac and nonneurological surgery under general anaesthesia.
Exposures:
Preoperative leisure-time physical activity assessed using the Godin Leisure-Time Exercise Questionnaire.
Main Outcome Measure:
Incidence of postoperative delirium within 7 days postoperatively as identified by the Chinese version of the 3-Minute Diagnostic Confusion Assessment Method.
Results:
The unadjusted postoperative delirium incidence was 28.4% in the low physical activity group versus 17.5% in the moderate-to-vigorous physical activity group, with an unadjusted odds ratio (95% confidence interval) of 0.53 [95% confidence interval (CI) 0.43 to 0.66). After adjustment for age, sex, and other confounders, the predicted incidence in the low physical activity group decreased to 24.1%, whereas that in the moderate-to-vigorous physical activity group increased to 18.6%, yielding a weighted odds ratio of 0.72 (95% CI 0.58 to 0.90). The postoperative delirium severity scores in both adjusted and unadjusted models markedly declined during postoperative days 1-3, then stabilised. The multivariable model identified significant positive associations between postoperative delirium severity and advanced age ( β = 0.064; 95% CI 0.032 to 0.096). Surgery time and intra-operative hypothermia are significant mediators.
Conclusion And Relevance:
Preoperative moderate-to-vigorous physical activity is associated with a significantly reduced risk of postoperative delirium in patients with silent brain infarction. Findings indicate that postoperative delirium severity is self-limiting, with symptoms resolving rapidly within 3 days after surgery. Surgery time and intra-operative hypothermia are significant mediating factors in this association.
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