Relationship between telomere length and postoperative delirium: a single center prospective observational pilot study.

Shorter telomere length (TL) and postoperative delirium (POD) are associated with aging and inflammation. We hypothesized that shorter TL may predict POD development. This pilot study investigated whether preoperative TL can predict POD occurrence. This single-center, prospective, observational study included 50 patients aged > 65 years scheduled for postoperative intensive care unit stay ≥ 2 days. Patients with Intensive Care Delirium Screening Checklist scores ≥ 4 were categorized into the POD group. Multivariable logistic regression analyses evaluated preoperative TL as a predictor of POD. Ten patients developed POD (POD group) while 40 did not (non-POD group). Preoperative TL showed no significant difference between groups (POD vs. non-POD: 296,502 vs. 327,884 RLU/µg DNA, p = 0.104). However, multivariable analyses revealed that preoperative TL ≥ 309,110 RLU/µg DNA significantly associated with decreased POD risk after adjusting for age (aOR: 0.132; 95% CI: 0.022-0.799; p = 0.047) and preoperative MMSE score (aOR: 0.153; 95% CI: 0.028-0.851; p = 0.032). Shorter preoperative TL was associated with POD development after adjusting for age and preoperative cognitive function. Future studies with larger sample sizes are needed to confirm these associations.