Welcome to Francis Academic Press

International Journal of Frontiers in Medicine, 2023, 5(5); doi: 10.25236/IJFM.2023.050512.

Progress in the study of the effect of preoperative oral carbohydrates on postoperative delirium in elderly patients


Ziyun Ma, Xiaoli Cai

Corresponding Author:
Xiaoli Cai

The Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, 830000, China


As the population ages, the number of elderly patients who choose to undergo surgical procedures is gradually increasing, but the incidence of postoperative delirium in elderly patients is gradually increasing due to their physiological changes, preoperative malnutrition, and prolonged preoperative fasting. The role of preoperative carbohydrates as a contemporary element of the rapid recovery surgery (ERAS) paradigm in preventing the onset of postoperative delirium has become a clinical research hotspot. A full understanding of the safety and feasibility of preoperative oral carbohydrates for elderly patients will help to reduce the incidence of postoperative delirium and promote early recovery of elderly patients. This paper presents a review of the effects of preoperative oral carbohydrates on POD in elderly patients.


preoperative oral carbohydrate, postoperative delirium, accelerated rehabilitation surgery, elderly patients

Cite This Paper

Ziyun Ma, Xiaoli Cai. Progress in the study of the effect of preoperative oral carbohydrates on postoperative delirium in elderly patients. International Journal of Frontiers in Medicine (2023), Vol. 5, Issue 5: 67-71. https://doi.org/10.25236/IJFM.2023.050512.


[1] OH E S, FONG T G, HSHIEH T T, et al. Delirium in Older Persons: Advances in Diagnosis and Treatment [J]. Jama, 2017, 318(12): 1161-74.

[2] EVERED L, SILBERT B, KNOPMAN D S, et al. Recommendations for the Nomenclature of Cognitive Change Associated with Anaesthesia and Surgery-2018 [J]. Anesthesiology, 2018, 129(5): 872-9.

[3] BAI J, LIANG Y, ZHANG P, et al. Association between postoperative delirium and mortality in elderly patients undergoing hip fractures surgery: a meta-analysis [J]. Osteoporos Int, 2020, 31(2): 317-26.

[4] AMER M, SMITH M, HERBISON G, et al. Network meta-analysis of the effect of preoperative carbohydrate loading on recovery after elective surgery [J]. Journal of British Surgery, 2017, 104(3): 187-97.

[5] SCHOLZ A F, OLDROYD C, MCCARTHY K, et al. Systematic review and meta-analysis of risk factors for postoperative delirium among older patients undergoing gastrointestinal surgery [J]. Br J Surg, 2016, 103(2): e21-8.

[6] AITKEN S J, BLYTH F M, NAGANATHAN V. Incidence, prognostic factors and impact of postoperative delirium after major vascular surgery: A meta-analysis and systematic review [J]. Vasc Med, 2017, 22(5): 387-97.

[7] SWARBRICK C, PARTRIDGE J. Evidence‐based strategies to reduce the incidence of postoperative delirium: a narrative review [J]. Anaesthesia, 2022, 77: 92-101.

[8] PANDHARIPANDE P, SHINTANI A, PETERSON J, et al. Lorazepam is an independent risk factor for transitioning to delirium in intensive care unit patients [J]. Anesthesiology, 2006, 104(1): 21-6.

[9] LEE H B, MEARS S C, ROSENBERG P B, et al. Predisposing factors for postoperative delirium after hip fracture repair in individuals with and without dementia [J]. J Am Geriatr Soc, 2011, 59(12): 2306-13.

[10] NEERLAND B E, HALL R J, SELJEFLOT I, et al. Associations between delirium and preoperative cerebrospinal fluid C‐reactive protein, interleukin‐6, and interleukin‐6 receptor in individuals with acute hip fracture [J]. Journal of the American Geriatrics Society, 2016, 64(7): 1456-63.

[11] ZHANG D F, SU X, MENG Z T, et al. Preoperative severe hypoalbuminemia is associated with an increased risk of postoperative delirium in elderly patients: Results of a secondary analysis [J]. J Crit Care, 2018, 44: 45-50.

[12] VELAYATI A, VAHDAT SHARIATPANAHI M, DEHGHAN S, et al. Vitamin D and Postoperative Delirium After Coronary Artery Bypass Grafting: A Prospective Cohort Study [J]. J Cardiothorac Vasc Anesth, 2020, 34(7): 1774-9.

[13] KONG C, ZHANG Y, WANG C, et al. Comprehensive geriatric assessment for older orthopedic patients and analysis of risk factors for postoperative complications [J]. BMC Geriatr, 2022, 22(1): 644.

[14] ZHU T, YU J, MA Y, et al. Effectiveness of Perioperative Comprehensive Evaluation of Hip Fracture in the Elderly [J]. Comput Intell Neurosci, 2022, 2022: 4124354.

[15] TAUTENHAHN H M, KRAUTSCHEID A, SCHULTE K, et al. [Prerehabilitation in frail patients: Frailty as a risk factor] [J]. Chirurg, 2020, 91(2): 103-8.

[16] SáNCHEZ C A, PAPAPIETRO V K. [Perioperative nutrition in ERAS Protocols] [J]. Rev Med Chil, 2017, 145(11): 1447-53.

[17] BERRETTA P, DE ANGELIS V, ALFONSI J, et al. Enhanced recovery after minimally invasive heart valve surgery: Early and midterm outcomes [J]. Int J Cardiol, 2022.

[18] ACKERMAN R S, TUFTS C W, DEPINTO D G, et al. How Sweet Is This? A Review and Evaluation of Preoperative Carbohydrate Loading in the Enhanced Recovery After Surgery Model [J]. Nutr Clin Pract, 2020, 35(2): 246-53.

[19] BILKU D K, DENNISON A R, HALL T C, et al. Role of preoperative carbohydrate loading: a systematic review [J]. Ann R Coll Surg Engl, 2014, 96(1): 15-22.

[20] TALUTIS S D, LEE S Y, CHENG D, et al. The impact of preoperative carbohydrate loading on patients with type II diabetes in an enhanced recovery after surgery protocol [J]. Am J Surg, 2020, 220(4): 999-1003.

[21] ASAKURA A, MIHARA T, GOTO T. The Effect of Preoperative Oral Carbohydrate or Oral Rehydration Solution on Postoperative Quality of Recovery: A Randomized, Controlled Clinical Trial [J]. PLoS One, 2015, 10(8): e0133309.

[22] SMITH M D, MCCALL J, PLANK L, et al. Preoperative carbohydrate treatment for enhancing recovery after elective surgery [J]. Cochrane Database Syst Rev, 2014, (8): Cd009161.

[23] AWAD S, VARADHAN K K, LJUNGQVIST O, et al. A meta-analysis of randomised controlled trials on preoperative oral carbohydrate treatment in elective surgery [J]. Clinical nutrition, 2013, 32(1): 34-44.

[24] CHENG P L, LOH E W, CHEN J T, et al. Effects of preoperative oral carbohydrate on postoperative discomfort in patients undergoing elective surgery: a meta-analysis of randomized controlled trials [J]. Langenbecks Arch Surg, 2021, 406(4): 993-1005.

[25] LJUNGQVIST O, FRANCIS N K, URMAN R D. Enhanced recovery after surgery: a complete guide to optimizing outcomes [M]. Springer, 2020.

[26] ACKERMAN R S, TUFTS C W, DEPINTO D G, et al. How sweet is this? A review and evaluation of preoperative carbohydrate loading in the enhanced recovery after surgery model [J]. Nutrition in Clinical Practice, 2020, 35(2): 246-53.

[27] ATKINS K J, SCOTT D A, SILBERT B, et al. Preventing delirium and promoting long-term brain health: a clinical trial design for the perioperative cognitive enhancement (PROTECT) trial [J]. Journal of Alzheimer's Disease, 2021, 83(4): 1637-49.

[28] ZHU T, YU J, MA Y, et al. Effectiveness of perioperative comprehensive evaluation of hip fracture in the elderly [J]. Computational Intelligence and Neuroscience, 2022, 2022.

[29] LIU H, DAI M, GUAN H, et al. Preoperative prognostic nutritional index value is related to postoperative delirium in elderly patients after noncardiac surgery: a retrospective cohort study [J]. Risk Management and Healthcare Policy, 2021: 1-8.

[30] OLOTU C, WEIMANN A, BAHRS C, et al. The perioperative care of older patients: time for a new, interdisciplinary approach [J]. Deutsches Ärzteblatt International, 2019, 116(5): 63.

[31] LESTER P E, RIPLEY D, GRANDELLI R, et al. Interdisciplinary protocol for surgery in older persons: development and implementation [J]. Journal of the American Medical Directors Association, 2022, 23(4): 555-62.

[32] MöRGELI R, WOLLERSHEIM T, SPIES C, et al. Wie können postoperative Komplikationen bei Patienten mit Frailty vermieden werden? [J]. AINS-Anästhesiologie Intensivmedizin Notfallmedizin Schmerztherapie, 2017, 52(11/12): 785-97.

[33] AMBULKAR R, MANAMPADI U, BHOSALE S, et al. Pre-induction Ultrasonographic Evaluation of Gastric Residual Volume in Elective Gastrointestinal Cancer Surgeries [J]. Indian J Surg Oncol, 2021, 12(4): 841-6.