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

• Published in: Medicine (Baltimore) 2023-02, Vol.102 (8), p.e32991-e32991
• Main Authors: Xiao, M. Z., Liu, C. X., Zhou, L. G., Yang, Y., Wang, Y.
• Format: Article
• Language: English
• Subjects: Cognitive Dysfunction - etiology; Delirium - prevention & control; Emergence Delirium; Humans; Narrative Review; Neuroinflammatory Diseases; Postoperative Complications - epidemiology; Risk Factors
• ISSN: 0025-7974; 1536-5964; 1536-5964
• DOI: 10.1097/MD.0000000000032991

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.