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Neurocognitive tests using the Mini-mental State Examination (MMSE) and the Beijing version of the Montreal Cognitive Assessment scales were carried out within 3\u00a0days before surgery and 4\u20137\u00a0days after surgery. Regional cerebral oxygen saturation (rScO<jats:sub>2<\/jats:sub>) was recorded in the operating room. Logistic regression analysis was used to evaluate the impact of preoperative LACI on POD and to explore the risk factors for POD.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 369 participants were analyzed, 161 in the preoperative LACI-positive group (P group), and 208 in the preoperative LACI-negative group (N group), respectively. The incidence of POD was 32.7% in our study. The incidence of POD was significantly higher in the P group than in the N group (39.1 vs 27.9%, risk ratio, 1.66; 95% CI 1.07\u20132.58; <jats:italic>P<\/jats:italic>\u2009=\u20090.022). Furthermore, the P group exhibited lower mean rScO<jats:sub>2<\/jats:sub> values during the procedure (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). In exploratory analysis, the advanced age (<jats:italic>P<\/jats:italic>\u2009=\u20090.005), sex (<jats:italic>P<\/jats:italic>\u2009=\u20090.038), and lower preoperative MMSE score (<jats:italic>P<\/jats:italic>\u2009=\u20090.019) were independent risk factors for POD in patients undergoing major abdominal surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions and implications<\/jats:title>\n            <jats:p>Preoperative LACI was common, and constituted a risk factor for POD in older patients undergoing abdominal surgery. Despite the frequent subclinical nature, the preoperative LACI led to lower mean rScO<jats:sub>2<\/jats:sub> during the procedure. These findings could help early identification of high-risk POD patients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s40520-024-02909-1","type":"journal-article","created":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T08:59:51Z","timestamp":1738141191000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The association between preoperative lacunar infarcts and postoperative delirium in elderly patients undergoing major abdominal surgery: a prospective cohort study"],"prefix":"10.1007","volume":"37","author":[{"given":"Danni","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pan","family":"Gu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuhao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuchen","family":"Yao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Fan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,1,29]]},"reference":[{"key":"2909_CR1","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1186\/s12893-018-0433-0","volume":"18","author":"C Gambardella","year":"2019","unstructured":"Gambardella C, Patrone R, Di Capua F et al (2019) The role of prophylactic central compartment lymph node dissection in elderly patients with differentiated thyroid cancer: a multicentric study. 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