Postoperative delirium, a common perioperative complication, is frequently observed in elderly surgical patients. Few studies have investigated the life rhythm of preoperative patients, and whether or not the preoperative life rhythm is associated with the development of postoperative delirium. The purpose of this study was to investigate the relationship between the preoperative circadian physical activity rhythm and postoperative delirium in cardiovascular surgery patients. A total of 43 patients who underwent cardiovascular surgery were included in this prospective study between July 2016 and September 2017 at Kobe University Hospital. All subjects used a “Life Microscope” wristband (a wristwatch-type terminal incorporating a 3-axis accelerometer monitoring) for 3–7 days at home before the planned surgery. Hourly mean values were calculated for the metabolic equivalents from the obtained activity amounts, and subsequently evaluated using cosine periodic regression analysis. The circadian rhythm parameters of mesor (24 h time series mean), amplitude (half the peak-trough variation), and acrophase (peak time) for the metabolic equivalents were obtained. The intensive care delirium screening checklist was used to assess for postoperative delirium. The acrophase significantly advanced in the postoperative delirium group (median, 11:55 h [interquartile range, 11:06–12:27 h]) compared to the group without postoperative delirium (median, 13:25 h [interquartile range, 12:52–14:13 h]) (p < .001). Furthermore, binary logistic regression analysis showed that advances in the physical activity phase remained independently associated with postoperative delirium (odds ratio, 0.003 [95% confidence interval, 0–0.63]). These results suggest that misalignment between advanced life rhythm before hospitalization and life rhythm after hospitalization might be associated with risk for developing postoperative delirium. Our results led us to speculate that adequate consideration of the patient’s life rhythm before hospitalization is needed to prevent postoperative delirium.

老年手术患者经常观察到术后ir妄，这是一种常见的围手术期并发症。很少有研究调查术前患者的生活节奏，以及术前生活节奏是否与术后del妄的发生有关。这项研究的目的是调查心血管手术患者的昼夜生理活动节律与术后ir妄之间的关系。在2016年7月至2017年9月之间，神户大学医院共纳入了43位接受了心血管外科手术的患者。在计划的手术之前，所有受试者在家中都要使用“生命显微镜”腕带（带有3轴加速度计监控功能的手表式终端），持续3-7天。从获得的活性量计算代谢当量的每小时平均值，然后使用余弦定期回归分析进行评估。获得了代谢当量的生物素的昼夜节律参数（24 h时间序列平均值），振幅（峰谷变化的一半）和顶期（高峰时间）。重症监护del妄筛查清单用于评估术后del妄。与没有术后ir妄的组（中位时间为13:25 h [四分位间距，12:25：中间，11:55 h [四分位间距，11：06–12：27 h]）相比，术后cro妄的顶峰期明显提前。 52–14：13 h]）（获得了代谢当量的生物素的昼夜节律参数（24 h时间序列平均值），振幅（峰谷变化的一半）和顶期（高峰时间）。重症监护del妄筛查清单用于评估术后del妄。与没有术后ir妄的组（中位时间为13:25 h [四分位间距，12:25：中间，11:55 h [四分位间距，11：06–12：27 h]）相比，术后cro妄的顶峰期明显提前。 52–14：13 h]）（获得了代谢当量的生物素的昼夜节律参数（24 h时间序列平均值），振幅（峰谷变化的一半）和顶期（高峰时间）。重症监护del妄筛查清单用于评估术后del妄。与没有术后ir妄的组（中位时间为13:25 h [四分位间距，12:25：中间，11:55 h [四分位间距，11：06–12：27 h]）相比，术后cro妄的顶峰期明显提前。 52–14：13 h]）（p <.001）。此外，二项逻辑回归分析表明，体育活动阶段的进展仍然与术后del妄独立相关（赔率，0.003 [95％置信区间，0-0.63]）。这些结果表明，住院前的晚期生活节奏与住院后的生活节奏之间的不一致可能与发生术后del妄的风险有关。我们的结果使我们推测，住院前需要充分考虑患者的生活节奏，以防止术后post妄。