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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

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).

Last updated: Aug 18, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Association between preoperative 25-hydroxyvitamin D3 levels and postoperative delirium in pediatric patients undergoing general anesthesia for laparoscopic surgery: a single-center retrospective study.

observational

Li L, Wang H, Liu J, Zhang Y, Yuan Z, Yu Y, Yu Y · Translational pediatrics (2026)

Participants: N/A
Duration: Not specified (retrospective, follow-up to postoperative day 7)
Intervention: Preoperative serum 25-hydroxyvitamin D3 measurement (observational, no intervention)
Outcome: Postoperative delirium assessed using the Cornell Assessment of Pediatric Delirium (CAPD) scale on postoperative days 1, 3, and 7
Effect Size: Adjusted odds ratio = 14.25 (95% CI: 3.33-61.0)
Population: Pediatric patients undergoing general anesthesia for laparoscopic surgery

Result:

PubMed: 42591949DOI: 10.21037/tp-2026-0297

Mechanism Graph

Vitamin D deficiency leads to reduced active vitamin D (1,25-dihydroxyvitamin D3) in the brain
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Vitamin D deficiency may impair neuroprotective and anti-inflammatory pathways
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Anesthesia and surgery induce neuroinflammation and oxidative stress
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Insufficient vitamin D may increase vulnerability to postoperative delirium

Limitations

  • ⚠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.

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References

  1. 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
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.