Editorial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Sep 15, 2024; 16(9): 3765-3770
Published online Sep 15, 2024. doi: 10.4251/wjgo.v16.i9.3765
Postoperative delirium: A tragedy for elderly cancer patients
Oguzhan Arun, Funda Arun
Oguzhan Arun, Department of Anesthesiology and Reanimation, Selcuk University Faculty of Medicine, Konya 42130, Türkiye
Funda Arun, Department of Pedodontics, Division of Anesthesiology, Selcuk University Faculty of Dentistry, Konya 42130, Türkiye
Author contributions: Arun O and Arun F conducted a literature search, analyzed the data, and wrote the manuscript; Both authors have read and approved the final manuscript.
Conflict-of-interest statement: Both authors have no relevant conflict of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Oguzhan Arun, MD, PhD, Professor, Department of Anesthesiology and Reanimation, Selcuk University Faculty of Medicine, Alaaddin Keykubat Kampus, Konya 42130, Türkiye. oguzarun@selcuk.edu.tr
Received: March 20, 2024
Revised: May 21, 2024
Accepted: May 29, 2024
Published online: September 15, 2024
Processing time: 172 Days and 19.5 Hours
Abstract

In this editorial, we comment on the article by Hu et al entitled “Predictive modeling for postoperative delirium in elderly patients with abdominal malignancies using synthetic minority oversampling technique”. We wanted to draw attention to the general features of postoperative delirium (POD) as well as the areas where there are uncertainties and contradictions. POD can be defined as acute neurocognitive dysfunction that occurs in the first week after surgery. It is a severe postoperative complication, especially for elderly oncology patients. Although the underlying pathophysiological mechanism is not fully understood, various neuroinflammatory mechanisms and neurotransmitters are thought to be involved. Various assessment scales and diagnostic methods have been proposed for the early diagnosis of POD. As delirium is considered a preventable clinical entity in about half of the cases, various early prediction models developed with the support of machine learning have recently become a hot scientific topic. Unfortunately, a model with high sensitivity and specificity for the prediction of POD has not yet been reported. This situation reveals that all health personnel who provide health care services to elderly patients should approach patients with a high level of awareness in the perioperative period regarding POD.

Keywords: Delirium; Anesthesia; Neurocognitive dysfunction; Postoperative cognitive dysfunction; Prevention; Risk management; Synthetic minority oversampling technique; Postoperative delirium; Elderly patients; Abdominal cancer

Core Tip: Postoperative delirium (POD) is a clinical complication with severe adverse consequences that can lead to death, especially in elderly patients. POD can occur at any time after surgery until hospital discharge. Predicting and preventing the disease among the most important clinical goals as the pathophysiology is not fully understood and effective treatment is not available. With this objective, many tools for assessment of delirium have been validated and various models have recently been developed with the help of machine learning using known POD risk factors.