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REVIEW article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1513833
Postoperative sepsis-associated neurocognitive disorder: Mechanisms, Predictive Strategies, and Treatment Approaches
Provisionally accepted
Zijin Gao 1
Zhenyu Xu 2*- 1 Department of Anesthesiology, Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
- 2 Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
Sepsis is a critical condition characterized by an abnormal immune response to infection, resulting in systemic inflammation, organ failure, and high mortality rate. Postoperative sepsis, accounting for nearly one-third of all sepsis cases, predominantly affects the elderly and individuals with pre-existing conditions, with fatality rates between 30% and 50%. Surgical stress induces immune, hormonal, and metabolic disturbances, heightening susceptibility to immune dysregulation and sepsis. Neurocognitive disorders related to postoperative sepsis, which share pathophysiological similarities with sepsis-associated encephalopathy, involve neuroinflammation, blood-brain barrier disruption, and mitochondrial dysfunction.Cognitive impairments, such as delirium, are frequent postoperative complications that vary in severity depending on the surgical complexity. This review examined the underlying mechanisms of these dysfunctions, the influence of different surgical procedures, and predictive and therapeutic strategies, including machine learning models, aimed at improving patient outcomes.
Keywords: Sepsis, Sepsis associated encephalopathy, Postoperative cognition dysfunction, delium, Sepsis treatment
Received: 19 Oct 2024; Accepted: 24 Mar 2025.
Copyright: © 2025 Gao and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zhenyu Xu, Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
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