AUTHOR=Hu Lin , Luo Manli , Huang Huifan , Wu Lanping , Ouyang Wen , Tong Jianbin , Le Yuan 

TITLE=Perioperative probiotics attenuates postoperative cognitive dysfunction in elderly patients undergoing hip or knee arthroplasty: A randomized, double-blind, and placebo-controlled trial

JOURNAL=Frontiers in Aging Neuroscience

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2022.1037904

DOI=10.3389/fnagi.2022.1037904

ISSN=1663-4365

ABSTRACT=<sec><title>Background</title><p>Postoperative cognitive dysfunction (POCD) is a common complication in elderly patients following surgery. The preventive and/or treatment strategies for the incidence remain limited.</p></sec><sec><title>Objective</title><p>This study aimed to investigate the preventive effect of perioperative probiotic treatment on POCD in elderly patients undergoing hip or knee arthroplasty.</p></sec><sec><title>Methods</title><p>After obtaining ethical approval and written informed consent, 106 patients (age ≥60 years) were recruited, who scheduled elective hip or knee arthroplasty, from 16 March 2021 to 25 February 2022 for this randomized, double-blind, and placebo-controlled trial. They were randomly assigned with a 1:1 ratio to receive either probiotics or placebo treatment (four capsules, twice/day) from hospital admission until discharge. Cognitive function was assessed with a battery of 11 neuropsychological tests on the admission day and the seventh day after surgery, respectively.</p></sec><sec><title>Results</title><p>A total of 96 of 106 patients completed the study, and their data were finally analyzed. POCD occurred in 12 (26.7%) of 45 patients in the probiotic group and 29 (56.9%) of 51 patients in the placebo group (relative risk [RR], 0.47 [95% confidence interval [CI], 0.27 to 0.81]; <italic>P</italic> = 0.003). Among them, mild POCD occurred in 11 (24.4%) in the probiotic group and 24 (47.1%) in the placebo group (RR, 0.52 [95% CI, 0.29 to 0.94]; <italic>P</italic> = 0.022). No significant difference in severe POCD incidence was found between the two groups (<italic>P</italic> = 0.209). Compared with the placebo group, the verbal memory domain cognitive function was mainly improved in the probiotic group.</p></sec><sec><title>Conclusion</title><p>Probiotics may be used perioperatively to prevent POCD development and improve verbal memory performance in elderly patients receiving hip or knee arthroplasty.</p></sec><sec><title>Clinical trial registration</title><p><ext-link ext-link-type="uri" xlink:href="http://www.chictr.org.cn" xmlns:xlink="http://www.w3.org/1999/xlink">www.chictr.org.cn</ext-link>, identifier: ChiCTR2100045620.</p></sec>