Impact of oxiracetam on postoperative delirium in elderly patients undergoing laparoscopic gastrointestinal surgery

doi:10.4240/wjgs.v18.i4.119293

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Apr 27, 2026 (publication date) through Apr 24, 2026

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Apr 27, 2026; 18(4): 119293
Published online Apr 27, 2026. doi: 10.4240/wjgs.v18.i4.119293

Table 1 Baseline characteristics of study subjects, n (%)

Characteristic	Control group	Oxiracetam group	Statistic	P value
n	91	82
Age (years old)	71 ± 9	71 ± 9	t = 0.09	0.926¹
Gender			χ² = 0.31	0.576²
Female	38 (41.8)	33 (40.2)
Male	53 (58.2)	49 (59.8)
BMI, mean ± SD	23.1 ± 4.1	23.3 ± 3.9	t = -0.46	0.645¹
ASA grade			χ² = 1.66	0.198²
II	72 (79.1)	65 (79.3)
III	19 (20.9)	17 (20.7)
Diagnosis			χ² = 3.68	0.165²
Colorectal cancer	63 (69.2)	57(69.5)
Others	28 (30.8)	25 (30.5)
Operation time (minute)	246 ± 132	246 ± 127	t = -0.05	0.962¹
Intraoperative blood loss (mL)	103 ± 134	113 ± 242	t = -0.34	0.736¹
Intraoperative blood transfusion	11 (12.1)	9 (11.0)	χ² = 0.20	0.654²
Hospital stay (days)	22.5 ± 5.0	20.7 ± 7.9	t = 1.83	0.070¹

¹Welch two sample t-test.

²Pearson’s χ² test.

ASA: American Society of Anesthesiologists; BMI: Body mass index.

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Table 2 Changes in Montreal Cognitive Assessment before and after intervention, mean (SD)

Treatment	Pre-operative	Post-operative	Change from baseline
Treatment	Pre-operative	Post-operative	mean (SD)	LS mean (95%CI)
Control group	24.7 (1.25)	24.3 (1.21)	-0.3 (0.81)	-0.36 (-0.61, -0.11)
Oxiracetam group	25.2 (1.70)	25.1 (2.21)	-0.2 (1.48)	-0.14 (-0.39, 0.11)

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Table 3 Relationship between oxiracetam and inflammatory factor levels

Time	Characteristic	Control group	Oxiracetam group	P value
n		91	82
Pre	IL-1β	1.25 (0.80, 1.71)	1.27 (0.87, 1.89)	0.792
	IL-2	1.95 (1.45, 2.34)	2.12 (1.54, 2.81)	0.371
	IL-6	9.5 (7.9, 10.7)	9.4 (7.8, 10.6)	0.831
	IL-8	26 (21, 30)	25 (20, 31)	0.582
	IL-10	1.24 (0.89, 2.34)	1.30 (0.90, 2.30)	0.711
	TNF-α	2.28 (1.07, 2.84)	1.78 (1.25, 2.56)	0.408
Day 1	IL-1β	1.95 (1.39, 2.98)	1.63 (1.08, 3.10)	0.012
	IL-2	1.79 (1.65, 2.07)	1.92 (1.42, 3.50)	0.222
	IL-6	79 (58, 89)	36 (27, 55)	< 0.001
	IL-8	28 (22, 36)	15 (11, 24)	< 0.001
	IL-10	3.4 (2.2, 4.9)	3.8 (2.4, 6.4)	0.314
	TNF-α	2.01 (1.31, 2.86)	1.78 (1.24, 2.53)	0.218
Day 2	IL-1β	2.33 (1.79, 2.89)	1.92 (1.45, 2.77)	0.011
	IL-2	1.56 (1.18, 1.85)	2.34 (1.34, 3.47)	< 0.001
	IL-6	76 (60, 94)	39 (22, 77)	< 0.001
	IL-8	41 (32, 49)	27 (17, 46)	< 0.001
	IL-10	2.9 (2.0, 5.1)	4.5 (2.5, 6.0)	0.008
	TNF-α	2.45 (1.18, 2.99)	2.01 (1.70, 2.92)	0.892
Day 7	IL-1β	1.76 (1.09, 2.58)	1.25 (0.97, 1.58)	0.005
	IL-2	1.61 (1.39, 2.01)	2.14 (1.34, 3.48)	0.013
	IL-6	31 (16, 44)	12 (9, 22)	< 0.001
	IL-8	19 (15, 24)	16 (12, 26)	0.093
	IL-10	2.15 (1.65, 3.27)	3.57 (1.78, 4.27)	0.012
	TNF-α	2.25 (1.65, 2.78)	2.12 (1.54, 2.76)	0.705

TNF-α: Tumor necrosis factor-α; IL: Interleukin.

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Table 4 Relationship between delirium and inflammatory factor levels

Time	Characteristic	Delirium	Non-delirium	P value
n		37	136
Pre	IL-1β	1.11 (0.75, 1.54)	1.15 (0.78, 1.56)	< 0.753
	IL-2	1.91 (1.35, 2.21)	1.95 (1.38, 2.25)	< 0.657
	IL-6	8.8 (7.7, 10.1)	8.6 (7.6, 10.3)	0.843
	IL-8	24 (19, 28)	20 (12, 48)	0.579
	IL-10	1.11 (0.88, 1.44)	1.18 (0.90, 1.46)	0.765
	TNF-α	1.69 (1.03, 2.54)	1.72 (1.05, 2.50)	0.821
Day 1	IL-1β	1.84 (1.44, 2.89)	1.68 (0.99, 3.88)	0.259
	IL-2	1.76 (1.57, 1.95)	2.39 (1.69, 4.07)	< 0.001
	IL-6	64 (42, 85)	38 (22, 83)	< 0.001
	IL-8	26 (20, 35)	15 (9, 26)	< 0.001
	IL-10	3.2 (2.1, 3.8)	6.0 (3.1, 8.8)	< 0.001
	TNF-α	1.79 (1.22, 2.67)	1.94 (1.39, 2.72)	0.461
Day 2	IL-1β	2.21 (1.78, 2.71)	2.06 (1.44, 3.89)	0.789
	IL-2	1.36 (1.11, 1.84)	2.48 (1.63, 3.83)	< 0.001
	IL-6	66 (37, 87)	63 (28, 107)	0.770
	IL-8	40 (31, 46)	28 (16, 54)	0.019
	IL-10	2.4 (1.7, 3.7)	5.8 (4.2, 9.3)	< 0.001
	TNF-α	2.00 (1.21, 2.84)	2.42 (1.76, 3.44)	0.021
Day 7	IL-1β	1.93 (1.13, 3.58)	1.24 (0.93, 1.55)	< 0.001
	IL-2	1.55 (1.30, 1.80)	2.34 (1.67, 4.22)	< 0.001
	IL-6	22 (11, 39)	17 (9, 32)	0.038
	IL-8	18 (14, 22)	22 (11, 62)	0.165
	IL-10	1.89 (1.45, 2.50)	4.18 (3.17, 6.58)	< 0.001
	TNF-α	2.30 (1.76, 3.21)	1.99 (1.35, 2.53)	0.003

TNF-α: Tumor necrosis factor-α; IL: Interleukin.

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Table 5 Relationship between oxiracetam and delirium incidence

Characteristic	Model 1			Model 2			Model 3
Characteristic	OR	95%CI	P value	OR	95%CI	P value	OR	95%CI	P value
Intervention
Control group	-	-		-	-		-	-
Oxiracetam group	0.27	0.15, 0.51	< 0.001	0.20	0.09, 0.42	< 0.001	0.12	0.04, 0.36	< 0.001

OR: Odds ratio; CI: Confidence interval.

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Citation: Lv BS, Wang W, Jin M, Ma Y, Wang JL, Gao H. Impact of oxiracetam on postoperative delirium in elderly patients undergoing laparoscopic gastrointestinal surgery. World J Gastrointest Surg 2026; 18(4): 119293
URL: https://www.wjgnet.com/1948-9366/full/v18/i4/119293.htm
DOI: https://dx.doi.org/10.4240/wjgs.v18.i4.119293

Lv BS, Wang W, Jin M, Ma Y, Wang JL, Gao H. Impact of oxiracetam on postoperative delirium in elderly patients undergoing laparoscopic gastrointestinal surgery. World J Gastrointest Surg 2026; 18(4): 119293 [DOI: 10.4240/wjgs.v18.i4.119293]

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