术后谵妄（POD）是一种常见的神经系统并发症，通常导致预后不良。早期识别高危患者对于预防 POD 至关重要。肌肉减少症是一种与年龄相关的老年综合征，其特征是骨骼肌质量和功能丧失，之前的研究表明，术前低肌肉质量可能是 POD 的预测因素。然而，术前肌少症与 POD 之间的关联仍有待充分阐明。本研究旨在探讨老年胃肠癌手术患者术前肌少症与POD的相关性。纳入接受胃肠癌手术的老年患者（≥60岁）。肌肉减少症的定义是根据国际物理与康复医学会肌肉减少症特别兴趣小组（ISarcoPRM）的定义，结合了术前肌肉质量（通过超声评估）和功能（通过椅子站立测试和握力评估）的损失。在术后7天内或出院前使用混乱评估法（CAM）或重症监护病房CAM（CAM-ICU）进行POD评估。多变量逻辑回归分析检查了术前肌少症与 POD 之间的相关性。此外，应用受试者工作特征（ROC）曲线分析术前肌少症对POD的预测效果。最终纳入130例患者，其中43例术前出现肌少症。 24名患者最终发生POD，发生率为18.5%。多变量分析结果表明，调整年龄≥70岁、术前简易精神状态检查评分和术中输血后，术前肌少症仍然与POD独立相关。术前肌少症预测 POD 的 ROC 曲线下面积为 0.680（95% 置信区间 0.557-0.804）。根据 ISarcoPRM 标准定义的术前肌少症与老年胃肠道癌症手术后患者的 POD 独立相关。版权所有 © 2024 Dong, Yu,张、李、李、李、李。

Postoperative delirium (POD) is a usual neurological complication, often leading to poor prognoses. Early identification of high-risk patients is crucial for preventing POD. Sarcopenia is an age-related geriatric syndrome characterized by the loss of skeletal muscle mass and function, and previous studies indicated that preoperative low muscle mass might be a predictor for POD. However, the association between preoperative sarcopenia and POD remains to be fully elucidated. This study was to explore the correlation between preoperative sarcopenia and POD following gastrointestinal cancer surgery in older patients.Older patients (≥60 years) undergoing gastrointestinal cancer surgery were enrolled. Sarcopenia was defined based on the Special Interest Group on sarcopenia of the International Society of Physical and Rehabilitation Medicine (ISarcoPRM), which combined the loss of muscle mass (evaluated by ultrasound) and function (assessed by chair stand test and handgrip strength) before surgery. POD assessment was performed using the Confusion Assessment Method (CAM) or CAM for the intensive care unit (CAM-ICU) during the first 7 days after surgery or before discharge. Multivariate logistic regression analysis examined the correlation between preoperative sarcopenia and POD. Moreover, the receiver operator characteristic (ROC) curve was applied to analyze the predictive effect of the preoperative sarcopenia in POD.One hundred and thirty patients were finally included, of which 43 patients presented with sarcopenia before surgery. Twenty-four patients ultimately developed POD, and the incidence was 18.5%. The results of the multivariate analyses demonstrated that preoperative sarcopenia was still independently associated with POD after adjusting for age ≥70 years, preoperative Mini-Mental State Examination score, and intraoperative blood transfusion. The area under the ROC curve of preoperative sarcopenia in predicting POD was 0.680 (95% confidence interval 0.557-0.804).Preoperative sarcopenia defined by ISarcoPRM criteria was independently associated with POD in geriatric patients after gastrointestinal cancer surgery.Copyright © 2024 Dong, Yu, Zhang, Li, Li, Li and Li.