Abstract
OBJECTIVE: To investigate the association between postoperative cognitive dysfunction (POCD) and anemia in elderly patients with gastrointestinal tumors. METHODS: A retrospective analysis was conducted on 184 elderly patients treated at Yanchang County People's Hospital from May 2019 to March 2022. The patients were divided into a normal hemoglobin group (n=109) and an anemia group (n=75) based on their preoperative hemoglobin levels. Cognitive function was assessed using MMSE and MoCA scales at preoperative day 1 and postoperative day 1, 3, and 7. Levels of S100β, TNF-α, and IL-6 were measured. Intraoperative data were recorded. POCD incidence was evaluated at 3 and 7 days postoperatively. Pearson correlation and ROC curve analyses were conducted, and logistic regression was conducted to identify risk factors for POCD. RESULTS: The anemia group had significantly lower postoperative MMSE and MoCA scores and higher levels of inflammatory factors (all P<0.05) compared to the normal hemoglobin group. No significant differences in intraoperative data were observed between the groups (P>0.05). POCD incidence on postoperative day 3 and 7 was higher in the anemia group (38.66% and 30.67%) compared to that in the normal group (11.01% and 7.34%) (P<0.05). AUCs for hemoglobin levels in predicting POCD on postoperative day 3 and 7 were 0.858 and 0.865. Independent risk factors for POCD included age >70 years, education ≤6 years, and anemia. CONCLUSIONS: Anemia is associated with lower cognitive function scores, higher POCD incidence, and increased inflammatory factors in elderly gastrointestinal tumor patients after operation.