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Background <p> Geriatric patients undergoing oral and maxillofacial surgery are at high risk of delayed neurocognitive recovery (dNCR), yet reliable predictive tools remain unavailable.</p> Methods <p>This prospective cohort study (July 2021–January 2025) enrolled patients aged ≥ 65 undergoing elective oral and maxillofacial surgery under general anaesthesia. Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were assessed at baseline and postoperative 1, 3, 7, and 30 days. Serum lipidomics analysis via liquid chromatography-mass spectrometry was performed preoperatively and 24&#xa0;h postoperatively. The predictive performance of lipid metabolites for dNCR was assessed using receiver operating characteristic curve analysis, with their independent association further evaluated by logistic regression.</p> Results <p>Among 160 patients, 52 patients (32.5%) developed dNCR. Preoperatively, dNCR patients exhibited significantly lower serum triglyceride (TG), particularly TG(58:7/22:5) (OR = 0.014, 95% CI 0.002 to 0.109, adjusted <i>P</i> &lt; 0.001) and TG(54:2/18:1) (OR = 0.051, 95% CI 0.010 to 0.252, adjusted <i>P</i> = 0.002), which demonstrated strong predictive performance (AUC = 0.86, sensitivity = 0.73, specificity = 0.85). Postoperatively, reduced levels of TG(58:7/22:5) (OR = 0.067, 95% CI 0.015 to 0.309, adjusted <i>P</i> = 0.003) and TG(54:2/18:1) (OR = 0.034, 95% CI 0.006 to 0.176, adjusted <i>P</i> &lt; 0.001) persisted in dNCR patients at 24&#xa0;h, retaining predictive value for dNCR (AUC = 0.82, sensitivity = 0.75, specificity = 0.78).</p> Conclusions <p>Low serum TG(58:7/22:5) and TG(54:2/18:1) are promising biomarkers for early prediction of dNCR, supporting lipidomics-guided perioperative neurocognitive risk stratification.</p>

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Low serum triglycerides related to delayed neurocognitive recovery in geriatric oral and maxillofacial surgery patients: A prospective cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月11日

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  • Jing Wang,
  • Yanyong Cheng,
  • Fan Wang,
  • Chuanyu Qi,
  • Yi Gao,
  • Tiannan Chen,
  • Jiayi Wang,
  • Jinnan Xu,
  • Ren Zhou,
  • Yanan Jiang,
  • Haoli Mao,
  • Jia Yan

摘要

Background

Geriatric patients undergoing oral and maxillofacial surgery are at high risk of delayed neurocognitive recovery (dNCR), yet reliable predictive tools remain unavailable.

Methods

This prospective cohort study (July 2021–January 2025) enrolled patients aged ≥ 65 undergoing elective oral and maxillofacial surgery under general anaesthesia. Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were assessed at baseline and postoperative 1, 3, 7, and 30 days. Serum lipidomics analysis via liquid chromatography-mass spectrometry was performed preoperatively and 24 h postoperatively. The predictive performance of lipid metabolites for dNCR was assessed using receiver operating characteristic curve analysis, with their independent association further evaluated by logistic regression.

Results

Among 160 patients, 52 patients (32.5%) developed dNCR. Preoperatively, dNCR patients exhibited significantly lower serum triglyceride (TG), particularly TG(58:7/22:5) (OR = 0.014, 95% CI 0.002 to 0.109, adjusted P < 0.001) and TG(54:2/18:1) (OR = 0.051, 95% CI 0.010 to 0.252, adjusted P = 0.002), which demonstrated strong predictive performance (AUC = 0.86, sensitivity = 0.73, specificity = 0.85). Postoperatively, reduced levels of TG(58:7/22:5) (OR = 0.067, 95% CI 0.015 to 0.309, adjusted P = 0.003) and TG(54:2/18:1) (OR = 0.034, 95% CI 0.006 to 0.176, adjusted P < 0.001) persisted in dNCR patients at 24 h, retaining predictive value for dNCR (AUC = 0.82, sensitivity = 0.75, specificity = 0.78).

Conclusions

Low serum TG(58:7/22:5) and TG(54:2/18:1) are promising biomarkers for early prediction of dNCR, supporting lipidomics-guided perioperative neurocognitive risk stratification.