Perioperative medicine & outcomes
Association between preoperative physical exercise and postoperative delirium in silent brain infarction: A multicentre prospective cohort study
Authors' conclusion
Preoperative moderate-to-vigorous physical activity is associated with a significantly reduced risk of postoperative delirium in patients with silent brain infarction.
Study context
- Population
- Adults with silent (asymptomatic) brain infarction scheduled for elective noncardiac, nonneurological surgery under GA; 4 tertiary centres in China, March 2024 to February 2025
- Participants
- 2,512 adults
- Exposure
- Moderate-to-vigorous vs low preoperative leisure-time physical activity
- Outcome
- Postoperative delirium (Chinese 3-Minute Diagnostic Confusion Assessment Method)
- Follow-up
- Within 7 days postoperatively
Methodological detailsmulticentre, causal inference models
- Multicentre
- Causal inference models
Main finding
As reported in the abstract
Postoperative delirium · within 7 days
Moderate-to-vigorous physical activity vs Low physical activityEstimate (95% CI)
Postoperative delirium
unadjusted OR 0.53(0.43–0.66)
Adjusted for age, sex, and other confounders
weighted OR 0.72(0.58–0.90)
Observational data: associations, not effects.
Further findings
Postoperative delirium severity scores · POD 1-3
- Markedly declined during POD 1-3, then stabilised (adjusted and unadjusted models)
Delirium severity and advanced age (multivariable model)
- β
- 0.064; 95% CI 0.032 to 0.096
Mediators
- Surgery time and intra-operative hypothermia are significant mediators
Original publication
Association between preoperative physical exercise and postoperative delirium in silent brain infarction: A multicentre prospective cohort study. Eur J Anaesthesiol. Published 4 April 2026. doi:10.
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