Abstract
This study aimed to investigate the relationship between postoperative delirium and long-term cognitive function in elderly women undergoing cervical cancer surgery, providing insights into the long-term effects of postoperative cognitive alterations. A retrospective analysis was conducted on 120 elderly women (≥60 years) who underwent cervical cancer surgery over the past decade. Patients were categorized into a postoperative delirium group (n = 45) and a non-delirium group (n = 75) based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria, with initial screening using the confusion assessment method. Cognitive function was assessed preoperatively, and at 1 year and 3 years postoperatively using the Mini-Mental State Examination (MMSE). Multivariate logistic regression analysis was performed to identify independent predictors of long-term cognitive decline, adjusting for potential confounders such as age, underlying health status, psychiatric history, and psychological distress. Postoperative delirium occurred in 37.5% (45/120) of patients. One year after surgery, MMSE scores were significantly lower in the delirium group (P < .05), and this difference persisted at 3 years (P < .05). Univariate regression analysis identified postoperative delirium, older age, poorer health status, psychiatric history, preoperative psychotropic drug use, longer hospital stay, pain scores, and psychological distress as significant risk factors for cognitive decline at both time points. Multivariate analysis confirmed that postoperative delirium (P < .001), age (P < .05), poorer health status (P < .05), psychiatric history (P < .001), preoperative psychotropic drug use (P < .05), and psychological distress (P < .001) were independent predictors of long-term cognitive decline. Length of hospital stay and pain scores were not significant in the multivariate model (P > .05). Postoperative delirium is a strong and persistent risk factor for long-term cognitive decline in elderly women following cervical cancer surgery. Psychiatric history and psychological distress further exacerbate cognitive deterioration. These findings highlight the urgent need for improved perioperative cognitive assessment and management strategies to reduce the long-term impact of postoperative delirium in this high-risk population.