Bridging the gaps in understanding POD and POCD: A thorough examination of genetic and clinical biomarkers

Abstract

This systematic review delves into the complex and multifaceted nature of Postoperative Delirium (POD) and Postoperative Cognitive Dysfunction (POCD), conditions sharing common phenotypes and risk factors. The pathophysiology of POD/POCD, particularly prevalent in vulnerable groups like the elderly, is explored, highlighting the roles of inflammation, cellular stress, and neural injuries. The review scrutinizes 24,354 research publications, selecting 176 and a subset of 24 for in-depth analysis, to unravel the intricate web of potential biomarkers and their associations with cognitive decline post-surgery. This systematic review was performed according to norms of Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). The findings underscore the lack of universally accepted biomarkers, reflecting the diversity in clinical presentations and the myriad of underlying pathophysiological mechanisms. The review also emphasizes the evolving nature of POCD's definition and the need for further research to elucidate the genetic underpinnings of these postoperative complications. Future directions in neuropsychology and biomedicine are proposed to bridge existing knowledge gaps and enhance our understanding of POD and POCD.