Habitual tea consumption and postoperative delirium after total hip/knee arthroplasty in elderly patients: The PNDABLE study

Brain and Behavior

Rui Dong¹  Yan‐lin Bi²  Xu Lin²  Bin Wang²  Xiao‐xuan Li³ 

[1] Department of Anesthesiology Drum Tower Hospital Affiliated to Nanjing University Medical School Nanjing China;Department of Anesthesiology Qingdao Municipal Hospital Affiliated to Qingdao University Qingdao China;Department of Anesthesiology Qingdao Women and Children's Hospital Qingdao China;

关键词: cholinergic nerve system;    elderly;    hip/knee arthroplasty;    postoperative delirium;    tea;   

DOI  :  10.1002/brb3.2612

来源: DOAJ

【 摘 要 】

Abstract Purpose To clarify the effects of habitual tea consumption on postoperative delirium (POD) in elderly patients undergoing total hip/knee arthroplasty. Patients and Methods A prospective cohort study was carried out at Qingdao Municipal Hospital Affiliated to Qingdao University between June 2020 and June 2021. A total of 332 patients aged 65–85 years undergoing total hip/knee arthroplasty under combined spinal and epidural anesthesia were enrolled from the Perioperative Neurocognitive Disorder and Biomarker Lifestyle (PNDABLE) study in the final analysis, consisting of 168 patients with habitual tea consumption and 164 patients with infrequent tea consumption. The primary endpoint was the effects of habitual tea consumption on POD and the incidence of POD, which was assessed by the Confusion Assessment Method (CAM) twice daily during the first 7 postoperative days, and POD severity was measured by the Memorial Delirium Assessment Scale (MDAS). The secondary endpoints were the concentrations of caffeine and tea polyphenols in plasma and cerebrospinal fluid (CSF), which were detected by the enzyme‐linked immunosorbent assay. Results POD occurred in 61 of 332 patients (18.37%), among whom 19 had habitual tea consumption (5.72%) and 42 had infrequent tea consumption (12.65%). Habitual tea consumption (odds ratio [OR] = 0.370, 95% confidence interval [CI]: 0.205–0.670, P = .001) was significantly associated with POD in the logistic analysis, and then after adjusting for age and American Society of Anesthesiologists (ASA) physical status (OR = 0.353, 95% CI: 0.190–0.655, P = .001). Furthermore, caffeine in T0 plasma (OR = 0.834, 95% CI: 0.752–0.924, P = .001), T1 plasma (OR = 0.818, 95% CI: 0.738–0.908, P < .001), and CSF (OR = 0.899, 95% CI: 0.820–0.984, P = .022) and tea polyphenols in T0 plasma (OR = 0.541, 95% CI: 0.416–0.704, P < .001), T1 plasma (OR = 0.477, 95% CI: 0.359–0.633, P < .001), and CSF (OR = 0.526, 95% CI: 0.397–0.696, P < .001) were associated with POD after adjusting for age and ASA physical status. Conclusion Habitual tea consumption may be associated with a lower incidence of POD in elderly patients.

【 授权许可】

Unknown