The Impact of Preoperative Depression on Postoperative Delirium in Elderly Chinese Patients: A Retrospective Multicenter Observational Study

August 1, 2026 updated by: Weidong Mi, Chinese PLA General Hospital

Preoperative Depression and Postoperative Delirium in Older Chinese Adults: A Multicenter Retrospective Cohort Study

This study is a retrospective analysis of a large-scale multicentre prospective cohort study that investigates the impact of preoperative depression on the incidence of postoperative delirium among elderly Chinese patients undergoing non-cardiac major surgery.

Study Overview

Status

Not yet recruiting

Conditions

Cohort Studies

Detailed Description

Preoperative depression is common among elderly surgical patients and may adversely affect postoperative outcomes. However, there is limited research on the relationship between preoperative depression and postoperative delirium (POD) in elderly patients undergoing non-cardiac major surgery. This study retrospectively analysed data from a prospective database (PDCEP) of patients aged 65 and above who underwent non-cardiac major elective surgery in multiple tertiary hospitals across 10 provinces in China. The study period spanned from April 1, 2020 to April 30, 2022.

Preoperative depression was assessed using the Patient Health Questionnaire-9 (PHQ-9), with PHQ-9 > 5 defined as the depression group and PHQ-9 < 5 as the non-depression group. Postoperative delirium was evaluated using the 3-minute Diagnostic Interview for CAM (3D-CAM). Binary logistic regression analyses were conducted, and propensity score-matching (PSM) and subgroup analyses were also applied.

Study Type

Observational

Enrollment (Estimated)

8000

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Name: Chen Cai
Phone Number: +8613718718781
Email: 1607125811@qq.com

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

Older Adult

Accepts Healthy Volunteers

Sampling Method

Probability Sample

Study Population

Elderly patients (aged ≥ 65 years) who completed the anxiety and depression assessment before elective non-cardiac major surgery were included in this study

Description

Inclusion Criteria:

1. Age ≥ 65 years, both genders 2. Elective non-cardiac major surgery 3. Completed preoperative depression assessment (PHQ-9) 4. Completed postoperative delirium assessment (3D-CAM)

Exclusion Criteria:

1. History of neurological or psychiatric disorders or use of neuropsychiatric medications 2. Impaired cognitive function or inability to complete preoperative follow-up 3. Transferred to ICU postoperatively 4. Missing delirium outcome data

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Number of groups / cohorts

Cohorts and Interventions

Group / Cohort
Depression group Patients with PHQ-9 scores greater than 5, indicating mild to severe depressive symptoms before surgery.
Non-depression group Patients with PHQ-9 scores less than 5, indicating minimal or no depressive symptoms before surgery

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative Delirium Time Frame: Delirium within 7 days of surgery	Postoperative delirium (POD) incidence was assessed using the 3-minute Diagnostic Interview for CAM (3D-CAM). The 3D-CAM is a validated tool for the detection of delirium in older adults. It evaluates four key features: acute onset and fluctuating course, inattention, disorganized thinking, and altered level of consciousness. If the patient was discharged, follow-up was conducted by telephone or email.	Delirium within 7 days of surgery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative Acute Pain Time Frame: Pain within 7 days of surgery	Postoperative acute pain was assessed using the Numerical Rating Scale (NRS). The NRS is an 11-point scale ranging from 0 (no pain) to 10 (worst possible pain).	Pain within 7 days of surgery
Postoperative Pulmonary Infection Time Frame: Within 7 days of surgery	Postoperative pulmonary infection was assessed through physical examination and laboratory tests (chest X-ray, white blood cell count, etc.).	Within 7 days of surgery

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Chinese PLA General Hospital

Collaborators

Peking University First Hospital

Xiangya Hospital of Central South University

Peking University People's Hospital

Sun Yat-sen University

Fudan University

The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School

Beijing Anzhen Hospital

China-Japan Friendship Hospital

Central South University

Zhejiang University

The Affiliated Hospital Of Guizhou Medical University

First Affiliated Hospital of Xinjiang Medical University

Taihe Hospital

First Affiliated Hospital of Guangxi Medical University

Beijing Tsinghua Changgeng Hospital

Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

August 15, 2026

Primary Completion (Estimated)

March 1, 2027

Study Completion (Estimated)

March 1, 2027

Study Registration Dates

First Submitted

July 20, 2026

First Submitted That Met QC Criteria

August 1, 2026

First Posted (Actual)

August 4, 2026

Study Record Updates

Last Update Posted (Actual)