European Journal of Anaesthesiology最新文献

{"title":"Frailty patterns in European surgical patients: The FRAGILE multicentre prospective cohort.","authors":"Cesar Aldecoa, Andres Zorrilla-Vaca, Javier Ripolles-Melchor, Maurizio Cecconi, Orestis Ioannidis, Başak Ceyda Meço, Jan Benes, Nicolai Goettel, Nuria Martin, Nádia Tenreiro, Alexandra Wüest, Luigi Marano, Maria Sotiropoulou, Gabriel Putzer, Olga Smékalová, Seppe Koopman, Felix Wantang Baños, Ane Abad-Motos, Carlos Ferrando","doi":"10.1097/EJA.0000000000002495","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002495","url":null,"abstract":"<p><strong>Background: </strong>Frailty represents a multidimensional decline in physiological reserve that increases vulnerability to surgical stress. Its perioperative dynamics and association with outcomes across diverse surgical populations remain insufficiently characterised.</p><p><strong>Objective: </strong>This study aimed to describe the prevalence of frailty before and after surgery and to evaluate its association with postoperative complications, mortality, and hospital length of stay.</p><p><strong>Methods: </strong>We conducted a prospective, multicentre European cohort study including adults undergoing elective or emergency surgery under general or regional anaesthesia across 64 participating centres in 10 countries. Each centre contributed data from one to three predefined recruitment days between April 2021 and December 2022. Frailty was assessed preoperatively and at 30 days using the Rockwood Clinical Frailty Scale (CFS), the FRAIL questionnaire, and the Barthel Index. The primary outcome was the association between preoperative frailty and 30-day postoperative complications (Clavien-Dindo ≥ II); secondary outcomes included 30-day mortality, postoperative cognitive impairment, and new-onset frailty.</p><p><strong>Results: </strong>Among 1472 patients (mean age 60.9 years; 52.9% male), preoperative frailty prevalence was 14.6% (FRAIL), 10.4% (CFS), and 10.4% (Barthel). Within 30 days, 11.9% of nonfrail patients became frail, increasing overall frailty prevalence to 21.2%. Postoperative complications occurred in 19.2% and mortality in 1.7%. Preoperative frailty was independently associated with complications: adjusted odds ratio (OR) 2.35 [95% confidence interval (CI) 1.53 to 3.60], P < 0.001); 30-day mortality OR 10.9 (95% CI 1.28 to 93.0), P = 0.029). Frailty was also associated with postoperative cognitive impairment: OR 3.47 (95% CI 1.98 to 6.08), P < 0.001).</p><p><strong>Conclusions: </strong>Frailty is common among surgical patients, increases after surgery, and independently predicts postoperative complications and mortality. These findings highlight frailty as a dynamic and potentially modifiable marker of surgical vulnerability that should be routinely assessed and integrated into perioperative care.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT04140370.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative delirium and 1-year functional decline, institutionalization and mortality.","authors":"Olga de la Varga-Martínez, Rosalía Navarro Pérez, Rocío López Herrero, Eduardo Santamaría-Vázquez, Gema Rodríguez-Cerón, Beatriz Martínez-Rafael, Ángel Becerra-Bolaños, Alma María Espinosa Moreno, Marta de la Rosa-Estadella, Natalia Bugueño, Marta Giné Servén, Adrián Martínez-López, Diana Marcela Narváez Cubillos, Marta Eugenia Infante Morales, Luis Aníbal Gómez Arredondo, Alma Casasempere Sanus, Jorge Almoguera-Fernández, Rebeca Badenes-García, Nekane Romero-García, Beneharo Darias-Delbey, Guadalupe Población García, Rita Veloso-de Sousa, María Heredia-Rodríguez, Cristina Tobar Gonzalo, José Miguel Marcos Vidal, Carolina Ferrer-Gómez, Lorena Varela Rodríguez, Laura Contreras López, Laura Pariente Juste, Marta Alonso Fernández, Ricardo Fernández Fernández, Cristina Sánchez González, Elena Del Val Peciña, María Aránzazu Rodríguez Conesa, Almudena González Pereira, Aurora Herrera Soto, Ángel Antonio Rodríguez Álvarez, Iria de la Torre Riveiro, Gustavo Illodo Miramontes, Itzamara Loo Yau, Carla Delgado Martí, Rodrigo Poves-Álvarez, Marina Varela Duran, Rafael Badenes, Eduardo Tamayo","doi":"10.1097/EJA.0000000000002499","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002499","url":null,"abstract":"<p><strong>Background: </strong>Postoperative delirium is a common and serious complication in older surgical patients and has been associated with increased morbidity, healthcare costs, long-term functional decline and mortality.</p><p><strong>Objective: </strong>To determine whether postoperative delirium is associated with functional status, quality of life, institutionalisation and mortality at 1 year after surgery in a large multicentre surgical cohort.</p><p><strong>Design: </strong>Prospective multicentre observational study.</p><p><strong>Setting: </strong>Forty-three hospitals in Spain. Surgical patients were recruited in November 2023 and assessed for delirium 48 h after surgery, with follow-up at 1 year.</p><p><strong>Patients, other participants: </strong>A total of 2442 adult surgical patients undergoing elective or urgent procedures requiring hospital admission. Postoperative delirium was assessed using the Confusion Assessment Method (CAM), CAM for the Intensive Care Unit (CAM-ICU) or the telephone-administered 4AT according to clinical setting.</p><p><strong>Interventions: </strong>None.</p><p><strong>Main outcome measures: </strong>Functional status and quality of life at 1 year assessed using the 12-item World Health Organization Disability Assessment Schedule (WHODAS 2.0). Secondary outcomes included institutionalisation and mortality.</p><p><strong>Results: </strong>After excluding 81 deaths and 462 nonresponders, the 1-year telephone follow-up was completed for 1899 patients. Postoperative delirium within the first 48 h was independently associated with a 4.6-point higher WHODAS score at 1 year: adjusted mean difference = 4.60 [95% confidence interval (CI), 1.57 to 7.64, P = 0.003]. Delirium was also associated with increased institutionalisation and higher mortality: odds ratio (OR) 2.5 (95% CI, 1.07 to 5.84, P = 0.03), and (16.7 vs. 3.1%; P < 0.001), including 30-day, 60-day, and 365-day mortality (all P < 0.001), respectively.</p><p><strong>Conclusions: </strong>Postoperative delirium is independently associated with long-term functional decline, loss of independence, institutionalisation and increased 1-year mortality. These findings highlight delirium as a key perioperative complication and support prevention strategies and structured long-term follow-up after surgery.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (identifier: NC-T06127901).</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and temporal validation of a simple CT-based body surface landmark approach for optimising central venous catheter tip position in the superior vena cava.","authors":"Tatsuya Kida, Masakazu Sumitomo","doi":"10.1097/EJA.0000000000002490","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002490","url":null,"abstract":"<p><strong>Background: </strong>Accurate positioning of central venous catheter (CVC) tips is essential to avoid complications, yet consistent appropriate placement within the superior vena cava remains challenging without a simple method for depth adjustment.</p><p><strong>Objectives: </strong>To develop and temporally validate a simple computed tomography-based (CT-based) body surface landmark approach for estimating optimal insertion depth (OID) and to assess its impact on appropriate catheter tip positioning.</p><p><strong>Design: </strong>Single-centre prospective observational cohort study.</p><p><strong>Setting: </strong>Tertiary care hospital in Japan; February 2017 to June 2019.</p><p><strong>Patients: </strong>Adult patients undergoing surgery requiring CVC placement via the right internal jugular vein with preoperative chest CT. After exclusions, 86 patients were included in the derivation cohort and 100 in the validation cohort.</p><p><strong>Intervention: </strong>In the derivation cohort, insertion depth was determined by the attending anaesthesiologist; in the validation cohort, it was determined using a model derived from the derivation cohort.</p><p><strong>Main outcome measure: </strong>The primary outcome was the proportion of appropriately placed catheter tips.</p><p><strong>Results: </strong>The final model retained the insertion point-to-body surface landmark distance (ILD), defined using a body surface landmark corresponding to the CT-identified midpoint of Zone B, as the sole predictor: OID (cm) = 0.64 × ILD + 3.64. The proportion of appropriately placed catheter tips was higher in the validation cohort than in the derivation cohort (92.0% (95% CI, 85.0 to 95.9%) vs. 73.3% (95% CI, 63.1 to 81.5%); P < 0.001). Model-guided placement was associated with increased likelihood of appropriate positioning (adjusted odds ratio 4.68 (95% CI, 1.97 to 12.27)). Model performance showed good calibration and moderate explanatory ability (R2 approximately 50%) in both cohorts.</p><p><strong>Conslusions: </strong>A CT-based body surface landmark approach was associated with improved consistency of appropriate CVC tip placement and enables patient-specific estimation of insertion depth.</p><p><strong>Trial registry: </strong>UMIN Clinical Trials Registry (UMIN000026252).</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic prophylaxis with vancomycin and gentamicin and the occurrence of acute kidney injury after cardiac surgery with cardiopulmonary bypass: A retrospective single-centre cohort study.","authors":"Stefan Andrei, Sophie Provenchère, Anne Boutten, Kevin Boussion, Tarek Sahnoun, Marylou Para, Dan Longrois, Philippe Montravers, Christian De Tymowski","doi":"10.1097/EJA.0000000000002519","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002519","url":null,"abstract":"<p><strong>Background: </strong>Vancomycin combined with gentamicin (VGA) is used as an alternative antibiotic prophylaxis in cardiac surgery when cephalosporins are contraindicated. However, the nephrotoxic potential of this combination raises concerns regarding postoperative acute kidney injury (AKI).</p><p><strong>Objective: </strong>This study aimed to evaluate the association between VGA prophylaxis and AKI occurrence in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB), while accounting for preoperative risk factors.</p><p><strong>Design: </strong>Retrospective single-centre study. AKI was defined according to KDIGO criteria within 7 postoperative days.</p><p><strong>Patients: </strong>Of the 8895 eligible patients between April 2013 and December 2021, 8198 were included. Subgroup analyses were performed according to preoperative AKI risk status (high-risk: insulin-dependent diabetes, cirrhosis, acute endocarditis, preoperative critical state, emergency surgery, or cardiac transplantation).</p><p><strong>Results: </strong>In our cohort, 7469 (91%) received cephalosporins and 729 (9%) received VGA. The overall AKI incidence was 16%. AKI occurred more frequently in the VGA group (29% vs. 15%, P < 0.001). After multivariable adjustment, VGA remained independently associated with AKI [odds ratio (OR) 1.29, 95% confidence interval (CI) 1.03 to 1.62, P = 0.024], confirmed by propensity score analysis (OR 1.32, 95% CI 1.09 to 1.60, P = 0.005). In subgroup analyses, VGA was significantly associated with AKI in high-risk patients (OR 1.53, 95% CI 1.14 to 2.04, P = 0.004), but not in low-risk patients (OR 1.19, 95% CI 0.87 to 1.64, P = 0.285).</p><p><strong>Conclusion: </strong>In this large retrospective cohort, VGA antibiotic prophylaxis was independently associated with increased AKI risk following cardiac surgery with CPB. This association was driven primarily by patients with preoperative risk factors for AKI. Alternative prophylactic regimens should be considered in high-risk patients when possible.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-specific intra-operative hypotension thresholds and risk of delayed graft function in kidney transplantation.","authors":"Oana Antal, Tudor Moisoiu, Robert Simon, Alina Daciana Elec, Adriana Milena Muntean, Georgeta Horceag, Robert Bolcas, Matei Florin Negrut, Adrian Stef, Mihai Oltean, Florin Ioan Elec","doi":"10.1097/EJA.0000000000002500","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002500","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-related variation in oxygen transport but stable mixed venous oxygen saturation in anaesthetised children.","authors":"Jacob Karlsson, Aron Törnwall, Anders Svedmyr, Per-Arne Lönnqvist","doi":"10.1097/EJA.0000000000002491","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002491","url":null,"abstract":"<p><strong>Background: </strong>Interpretation of cardiovascular function during paediatric anaesthesia requires knowledge of normal ranges of cardiac output (CO) and oxygen transport. However, most available paediatric haemodynamic data originate from awake or critically ill populations, and flow-based variables are rarely available during routine anaesthesia.</p><p><strong>Objectives: </strong>To characterise age-related variation in CO and oxygen transport variables in anaesthetised children and to evaluate whether mixed venous oxygen saturation (SvO2) remains stable across paediatric age groups.</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Setting: </strong>Single tertiary paediatric university hospital. Study period: retrospective data from 2016 to 2024.</p><p><strong>Patients: </strong>Fifty-eight anaesthetised children with structurally normal cardiac physiology undergoing elective surgery or catheter-based interventions.</p><p><strong>Interventions: </strong>None.</p><p><strong>Main outcome measures: </strong>CO, stroke volume (SV), cardiac index (CI), oxygen delivery (DO2), and SvO2 measured using capnodynamic assessment of CO and SvO2 under stable baseline anaesthesia.</p><p><strong>Results: </strong>CO, SV, and absolute DO2 increased significantly with age (all P < 0.0001). Indexed variables demonstrated age-dependent patterns: CI and DO2 index varied across age groups (P < 0.0001), with infants showing lower values compared with older children. In contrast, SvO2 did not differ between age groups (P = 0.19) and showed no linear association with age (P = 0.10).</p><p><strong>Conclusion: </strong>Absolute and indexed CO and DO2 variables demonstrated age-dependent variation in anaesthetised children, whereas SvO2 remained relatively stable across developmental stages. This stability suggests that SvO2 may represent a physiologically robust and age-independent indicator of adequate systemic DO2 during paediatric anaesthesia.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twelve tips for implementing patient-centred precision care in anaesthesia.","authors":"Basak Ceyda Meco, Karina Jakobsen, Wolfgang Buhre, Edoardo De Robertis, Maria Wittmann, Anthony Absalom, Finn Radtke, Joana Berger-Estilita","doi":"10.1097/EJA.0000000000002516","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002516","url":null,"abstract":"<p><p>Patient-centred precision care [(PC)2] is a new paradigm in anaesthesia that applies individualised care principles to tailor perioperative care to individual patient characteristics, preferences, and values. This individualised strategy aims to optimise anaesthetic effectiveness, minimise side effects, and align care with what matters most to patients - whether survival, cognitive preservation, pain control, or rapid functional recovery. By considering elements such as genetics, comorbidities, environmental influences, and lifestyle, (PC)2 improves outcomes and fosters long-term health and cost-effectiveness. Despite its promise, implementing (PC)2 faces challenges. Healthcare systems often prioritise efficiency over individualisation, while clinicians may focus on short-term outcomes. Regulatory hurdles and fragmented stakeholder input sometimes hinder industry efforts. To guide practical application, we present 12 practice recommendations for integrating (PC)2 into routine anaesthesia practice. These recommendations were derived from our experience implementing (PC)2 approaches, including Enhanced Recovery After Surgery, the Safe Brain Initiative, and the Brain Health Initiative. We also highlight the importance of evidence-based practice, health economic awareness, pragmatic clinical solutions, and the development of continuous quality improvement processes to promote sustainable excellence in care. Together, these strategies offer a roadmap for clinicians and organisations to deliver more precise, patient-specific, and effective anaesthesia, ultimately leading to better perioperative outcomes and experiences. Successful adoption of (PC)2 in real-world practice requires systemic alignment, a feedback-oriented culture, and active leadership engagement. This review highlights that these organisational elements are crucial for implementing (PC)2 across diverse healthcare settings.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms for why a short course of opioid therapy for acute back and neck pain led to worse long term pain: Secondary mediation analysis of a randomised controlled trial.","authors":"Zhiwei Yang, Chung-Wei Christine Lin, Caitlin M P Jones, Laurent Billot, Sana Shan, Richard O Day, Melanie Hamilton, Bart Koes, Christopher G Maher, Andrew J McLachlan, Hanan McLachlan, Melissa Webb, Aidan G Cashin","doi":"10.1097/EJA.0000000000002518","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002518","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current state of simulation-based education and training in anaesthesiology and intensive care specialist residency programmes: A European cross-sectional national anaesthesiologists societies survey.","authors":"Daniel Diabelko, Tereza Prokopová, Jan Hudec, Crina L Burlacu, Anne Marie Camilleri Podesta, Petr Štourač","doi":"10.1097/EJA.0000000000002496","DOIUrl":"10.1097/EJA.0000000000002496","url":null,"abstract":"<p><strong>Background: </strong>Simulation-based education and training (SBET) is as an essential component of competency-based education in anaesthesiology and intensive care medicine endorsed by European training standards. Therefore, data on its formal integration into national residency curricula across Europe should be regularly updated.</p><p><strong>Objectives: </strong>To describe the current implementation and structure of SBET in anaesthesiology and intensive care residency programmes across countries affiliated with the European Society of Anaesthesiology and Intensive Care (ESAIC).</p><p><strong>Design: </strong>International cross-sectional survey.</p><p><strong>Setting: </strong>A pan-European survey conducted within the ESAIC framework between 22 January and 17 February 2026.</p><p><strong>Participants: </strong>Representatives of the National Anaesthesiologists Societies Committee (NASC) and ESAIC Simulation Ambassadors with responsibility for postgraduate education or simulation programmes.</p><p><strong>Interventions: </strong>None.</p><p><strong>Main outcome measures: </strong>The primary objective of this study was to collect data on the prevalence of mandatory SBET programmes, training frequency, modalities and thematic content, funding mechanisms, integration into working hours, and the perceived barriers in countries without mandatory programmes.</p><p><strong>Results: </strong>Forty-three responses from ESAIC member countries were analysed. Mandatory SBET within national curricula was reported in 19 (44.2%) countries, while 8 (18.6%) countries recommended SBET, and 16 (37.2%) reported no formal integration. Among countries with mandatory programmes, high-fidelity simulation was required in 16 of 19 (84.2%). The number of required simulation training days varied substantially between countries. Funding for mandatory SBET was mostly provided by employers (57.9%). Among countries without mandatory programmes, 17 of 24 (70.8%) reported plans to introduce mandatory SBET, often within the next five years.</p><p><strong>Conclusions: </strong>Substantial heterogeneity persists in the integration of SBET in European anaesthesiology and intensive care residency curricula. Although fewer than half of countries currently mandate SBET, many report plans to introduce such programmes in the future. These findings highlight both existing variability and the ongoing development of SBET within European anaesthesiology and intensive care training systems.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov ID: NCT07110012.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between preoperative physical exercise and postoperative delirium in silent brain infarction: A multicentre prospective cohort study.","authors":"Hengjun Wan, Denghui Huang, Yuhang Gao, Ana Kowark, Mark Coburn, Qing Zhong, Qian Liu, Xuping Hu, Xuelian Li, Xiaoxia Duan","doi":"10.1097/EJA.0000000000002394","DOIUrl":"10.1097/EJA.0000000000002394","url":null,"abstract":"<p><strong>Background: </strong>Evidence is lacking regarding the association between preoperative leisure-time physical activity and postoperative delirium occurrence in high-risk populations with concomitant silent brain infarction.</p><p><strong>Objective: </strong>This study aimed to use causal inference models to explore the potential association between leisure-time physical activity before surgery and postoperative delirium occurrence.</p><p><strong>Design: </strong>Multicentre prospective cohort study.</p><p><strong>Settings: </strong>Four tertiary care medical centres in China from March 2024 to February 2025.</p><p><strong>Participants: </strong>This study enrolled 2512 adult patients with asymptomatic cerebral infarction between 2024 and 2025 who were scheduled to undergo elective noncardiac and nonneurological surgery under general anaesthesia.</p><p><strong>Exposures: </strong>Preoperative leisure-time physical activity assessed using the Godin Leisure-Time Exercise Questionnaire.</p><p><strong>Main outcome measure: </strong>Incidence of postoperative delirium within 7 days postoperatively as identified by the Chinese version of the 3-Minute Diagnostic Confusion Assessment Method.</p><p><strong>Results: </strong>The unadjusted postoperative delirium incidence was 28.4% in the low physical activity group versus 17.5% in the moderate-to-vigorous physical activity group, with an unadjusted odds ratio (95% confidence interval) of 0.53 [95% confidence interval (CI) 0.43 to 0.66). After adjustment for age, sex, and other confounders, the predicted incidence in the low physical activity group decreased to 24.1%, whereas that in the moderate-to-vigorous physical activity group increased to 18.6%, yielding a weighted odds ratio of 0.72 (95% CI 0.58 to 0.90). The postoperative delirium severity scores in both adjusted and unadjusted models markedly declined during postoperative days 1-3, then stabilised. The multivariable model identified significant positive associations between postoperative delirium severity and advanced age ( β  = 0.064; 95% CI 0.032 to 0.096). Surgery time and intra-operative hypothermia are significant mediators.</p><p><strong>Conclusion and relevance: </strong>Preoperative moderate-to-vigorous physical activity is associated with a significantly reduced risk of postoperative delirium in patients with silent brain infarction. Findings indicate that postoperative delirium severity is self-limiting, with symptoms resolving rapidly within 3 days after surgery. Surgery time and intra-operative hypothermia are significant mediating factors in this association.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"810-819"},"PeriodicalIF":7.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}