Associations between oral frailty, oral microbiota composition, and postoperative delirium in older adult patients

作者：Xiaoyi Hu, Huawei Duan, Lei‐yuan Wang, Q Q Liu, Hao Yao, Daqing Ma, Dong‐Xin Wang, Jianjun Yang, Mu‐Huo Ji · 发表于：Journal of the American Geriatrics Society · 年份：2024 · DOI：10.1111/jgs.19315 · 被引用次数：9 · 研究领域：Intensive Care Unit Cognitive Disorders、Oral microbiology and periodontitis research、Dental Health and Care Utilization

BACKGROUND: Poor oral health, prevalent among the older adults, can undermine overall health and contribute to frailty. Older adults experiencing oral frailty and dysbiosis potentially face an elevated risk of postoperative delirium. This study aims to explore the influence of oral frailty and changes in oral microbiota composition on occurrence of postoperative delirium in older adult patients undergoing non-cardiac surgery. METHODS: A total of 303 older adult patients undergoing non-cardiac surgeries were recruited in the Second Affiliated Hospital of Nanjing Medical University from July 2023 to December 2023. Oral swabs for oral microbiota analyses were collected before surgery. Subsequently, after propensity score matching, 21 samples from patients with postoperative delirium and 21 samples from patients without postoperative delirium were analyzed for oral microbiota. Our primary objective was to determine the association between oral frailty, changes in oral microbiota composition, and the occurrence of postoperative delirium. RESULTS: Oral frailty emerged as an independent risk factor for postoperative delirium [HR = 1.75; 95% CI = (1.04-2.96); p = 0.035]. Additionally, patients with postoperative delirium demonstrated lower oral microbiota diversity, as indicated by a reduced Chao index compared with those without postoperative delirium (p = 0.034). A significant association was also found between the dysbiosis index and postoperative delirium (p < 0.001). ROC analysi...