ArticleFrontiers in medicine2026
Sufentanil increases delirium risk compared to fentanyl in elderly perioperative ischemic stroke patients: a retrospective cohort study.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Perioperative ischemic stroke (PIS) and postoperative delirium (POD) are each serious central nervous system complications. When they occur together, they present a potentially devastating but largely understudied condition. Evidence on risk factors for this combined pathology is scarce. This study examined the incidence and prognosis of PIS complicated by POD and evaluated whether intraoperative opioid choice, fentanyl versus sufentanil, affects the risk of this dual complication. Methods: We retrospectively analyzed 376,933 patients who underwent non-cardiac surgery between January 2008 and August 2019. After applying exclusion criteria, 525 patients with PIS were identified. Of these, 178 elderly patients (≥ 65 years) formed the study cohort. Kaplan-Meier survival curves were used to compare overall survival between patients with and without POD, with group differences assessed by the log-rank test. Patients were categorized into a fentanyl group ( Results: The overall POD incidence among elderly PIS patients was 40.4% (72/178). Patients who developed POD had obviously worse survival compared to those who did not (30% Conclusion: In elderly patients with PIS, intraoperative fentanyl use was associated with a significantly lower risk of POD compared with sufentanil. Opioid selection may represent a modifiable risk factor in this high-risk population, offering an opportunity to improve anesthetic management and postoperative outcomes.
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