J Anesth Perioper Med. 2017;4(4):162-168. https://doi.org/10.24015/ebcmed.japm.2017.0056

Decreased Cerebral Glucose Metabolism in Elderly Patients with Postoperative Delirium: A Case-Control Study

Hao Ma1,2, Yan Liao1, Yi Mo2, Zu-Rong Li2, Qin Liao1, Yi-Chun Wang2, Kai-Ming Duan1, Ming-Hua Chen1, and Wen Ouyang1

From the 1Department of Anesthesiology, the Third Xiangya Hospital, Central South University, Changsha, China; 2Department of Anesthesiology, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.

Correspondence to Dr. Wen Ouyang at ouyangwen133@vip.sina.com.

EBCMED ID: ebcmed.japm.2017.0056 DOI: 10.24015/ebcmed.japm.2017.0056


Postoperative delirium (POD) is a common postoperative complication in elderly patients. Previous studies have investigated the risk factors and the methods of prevention and treatment of POD. However, the pathogenesis of POD remains unclear. Here we tried to investigate the relationship between cerebral energy metabolism and POD in elderly patients undergoing surgery.

We performed a case-control study of elderly patients who underwent major abdominal surgery from January 2011 to December 2011. Cerebral glucose metabolism was detected by positron emission tomography with 18F-fluorodeoxyglucose (18F-FDG-PET) and was evaluated by SUV value. POD was diagnosed according to the Confusion Assessment Method for the ICU (CAM-ICU).

In our case-control study, a total of 2195 patients were admitted to ICU after major abdominal surgery, and 42 of them developed hyperactive POD within 48 h after surgery. POD incidence was 1.91%(42/2195). Ultimately, 13 patients with POD were enrolled in the delirium group from the 42 POD patients (n = 13). 13 patients without POD were randomly selected to serve as control group (n = 13). No significant differences in demographic data, surgical duration, educational level, and key physiological signs and fasting blood sugar level were found between patients with and without POD (P > 0.05, respectively). However, patients with POD displayed lower SUV values in the entire cerebral cortex, particular in parietal, temporal and frontal cortex when compared with patients without POD (P < 0.05, respectively).

Elderly patients with POD displayed lower cerebral glucose metabolism in the entire cerebral cortex, suggesting that energy deficit is closely associated with POD in elderly patients. (Funded by the National Natural Science Foundation of China and Hunan Provincial Science and Technology Department of China.)

Article Type
Original Article

Declaration of Interests
The authors have no other potential conflicts of interest for this work.

This study was supported by grants from the National Natural Science Foundation of China (No.81371216) and Hunan Provincial Science and Technology Department of China(No. 2013SK3054).

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