Background/Objectives: Postoperative delirium (POD) is a common postoperative complication, especially in the elderly, and is associated with a worsening prognosis, prolonged hospitalization and reduced quality of life of patients. A growing body of research indicates that disorders of the composition of the gut microbiota and dysfunction of the gut–brain axis may play a key role in the pathogenesis of POD. Methods: The aim of this review was to assess the association between the gut microbiota and the occurrence of POD. This review was carried out in accordance with the JBI and PRISMA-ScR guidelines, searching for publications in six databases and selecting them according to PCC criteria. Finally, seven works were included in the analysis after an independent assessment. Conclusions: The available studies indicate that disorders of the gut microbiota and related metabolic and immune changes may significantly increase the risk of POD. It has been shown that certain bacteria and metabolites, such as SCFAs or indoles, can perform both protective and conducive functions for the development of POD. Understanding these mechanisms opens up the prospect of developing new preventive and therapeutic strategies based on the modulation of the gut microbiota.
DOI: https://doi.org/10.3390/nu18081201
Publish Year: 2026
