Perioperative medicine & outcomes
Hospital exposome and physiological resilience are associated with postoperative delirium, major complications, and long-term cognitive decline in older adults undergoing cancer surgery: A prospective multidomain cohort study
Authors' conclusion
In this single-centre prospective observational cohort study, hospital environmental burden and multidomain physiological resilience were associated with postoperative vulnerability in older adults undergoing cancer surgery.
Study context
- Population
- Patients aged ≥60 years undergoing elective gastrointestinal cancer surgery, tertiary academic hospital
- Participants
- 420 patients
- Exposure
- Higher vs lower hospital environmental burden and physiological resilience
- Outcome
- POD
Methodological detailshypothesis-generating, prespecified statistical analysis plan, single-centre
- Hypothesis-generating
- Prespecified statistical analysis plan
- Single-centre
Main finding
As reported in the abstract
Adjusted odds ratio (95% CI)
Hospital environmental burden (per SD increase)multivariable adjustment
1.78(1.35–2.34)
Physiological resilience (higher)
0.62(0.48–0.81)
Per SD increase, as printed
- Postoperative delirium (POD) incidence
- 21.4%
Observational data: associations, not effects.
Further findings
Postoperative complications
- Higher environmental burden associated with increased odds; higher physiological resilience with lower risk
Integrated exposome-resilience profile: delirium, longitudinal cognitive decline, disease-free survival
- Graded associations
- Exploratory analyses
Mediation by physiological resilience
- Statistically consistent with partial mediation of environmental burden–postoperative outcome associations
- Exploratory; do not imply causal or mechanistic relationships
Original publication
Hospital exposome and physiological resilience are associated with postoperative delirium, major complications, and long-term cognitive decline in older adults undergoing cancer surgery: A prospective multidomain cohort study. Eur J Anaesthesiol. Published 31 August 2026. doi:10.
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