Preoperative vitamin D deficiency is associated with a substantially increased risk of postoperative delirium in pediatric patients undergoing general anesthesia for laparoscopic surgery
In a single-center retrospective study of 320 pediatric patients undergoing laparoscopic surgery under general anesthesia, the incidence of postoperative delirium (POD) was 80.3% (257/320) based on CAPD score ≥9. Patients with POD had significantly lower preoperative serum 25(OH)D3 levels, and multivariable analysis showed that vitamin D deficiency (<30 ng/mL) was independently associated with a higher risk of POD (adjusted OR=14.25; 95% CI: 3.33-61.0; P<0.001). The association remained robust after adjusting for postoperative sleep quality (OR=8.15; 95% CI: 1.88-35.3; P=0.005).
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Preoperative vitamin D deficiency is associated with a substantially increased risk of postoperative delirium in pediatric patients undergoing general anesthesia for laparoscopic surgery The current body of evidence comprises 1 study. EvidenceHub rates the overall confidence at 34/100 (low).
The Claim
Preoperative vitamin D deficiency is associated with a substantially increased risk of postoperative delirium in pediatric patients undergoing general anesthesia for laparoscopic surgery
This conclusion is most relevant to: Pediatric patients undergoing general anesthesia for laparoscopic surgery.
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Association between preoperative 25-hydroxyvitamin D3 levels and postoperative delirium in pediatric patients undergoing general anesthesia for laparoscopic surgery: a single-center retrospective study. (Translational pediatrics, 2026) —
How It Works
The proposed biological pathway:
- ▸Vitamin D deficiency leads to reduced active vitamin D (1,25-dihydroxyvitamin D3) in the brain
- ▸Vitamin D deficiency may impair neuroprotective and anti-inflammatory pathways
- ▸Anesthesia and surgery induce neuroinflammation and oxidative stress
- ▸Insufficient vitamin D may increase vulnerability to postoperative delirium
Who Might Benefit
Evidence fit by population:
- ▸Pediatric patients undergoing general anesthesia for laparoscopic surgery
Recommended Dose
N/A
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Retrospective single-center design, which may introduce selection bias and limit generalizability
- ▸Observational study cannot establish causality; residual confounding may exist despite multivariable adjustment
- ▸The CAPD scale may overestimate delirium incidence in pediatric populations, as the 80.3% rate is high
- ▸No data on vitamin D supplementation or dietary intake during the study period
Frequently Asked Questions
What is the incidence of postoperative delirium in pediatric patients after laparoscopic surgery?▼
In this study, the incidence was 80.3% (257/320) based on a CAPD score ≥9.
How is vitamin D deficiency defined in this study?▼
Vitamin D deficiency was defined as preoperative serum 25-hydroxyvitamin D3 levels less than 30 ng/mL.
What is the adjusted odds ratio for postoperative delirium in vitamin D deficient children?▼
The adjusted odds ratio was 14.25 (95% CI: 3.33-61.0; P<0.001), indicating a substantially higher risk.
Should preoperative vitamin D screening be recommended for pediatric surgical patients?▼
The authors suggest that preoperative screening for vitamin D deficiency may help identify at-risk children, but randomized controlled trials are needed to confirm whether supplementation reduces delirium.
References
- 1.Li L, Wang H, Liu J, Zhang Y, Yuan Z, Yu Y, Yu Y. “Association between preoperative 25-hydroxyvitamin D3 levels and postoperative delirium in pediatric patients undergoing general anesthesia for laparoscopic surgery: a single-center retrospective study..” Translational pediatrics, 2026. PMID: 42591949 DOI: 10.21037/tp-2026-0297