Postoperative delirium, neuroinflammation, and influencing factors of postoperative delirium: A review

Medicine (Baltimore). 2023 Feb 22;102(8):e32991. doi: 10.1097/MD.0000000000032991.

Abstract

Postoperative delirium (POD) is an acute cognitive dysfunction that is mainly characterized by memory impairment and disturbances in consciousness. POD can prolong the hospital stay and increase the 1-month mortality rate of patients. The overall incidence of POD is approximately 23%, and its prevalence can go up to 50% in high-risk surgeries. Neuroinflammation is an important pathogenic mechanism of POD that mediates microglial activation and leads to synaptic remodeling. Neuroinflammation, as an indispensable pathogenesis of POD, can occur due to a variety of factors, including aseptic inflammation caused by surgery, effects of anesthetic drugs, disruption of the blood-brain barrier, and epigenetics. Understanding these factors and avoiding the occurrence of risk factors may help prevent POD in time. This review provides a brief overview of POD and neuroinflammation and summarizes various factors affecting POD development mediated by neuroinflammation, which may serve as future targets for the prevention and treatment of POD.

Publication types

  • Review

MeSH terms

  • Cognitive Dysfunction* / etiology
  • Delirium* / prevention & control
  • Emergence Delirium*
  • Humans
  • Neuroinflammatory Diseases
  • Postoperative Complications / epidemiology
  • Risk Factors