This study aims to explore the association between perioperative homocysteine (Hcy) levels and their pre-to-postoperative changes with postoperative complications and all-cause mortality in elderly patients undergoing non-cardiac surgery. Besides, the dynamic changes in Hcy levels may reflect metabolic shifts, highlighting their potential value in predicting adverse postoperative outcomes. These findings suggest that monitoring perioperative Hcy levels and their changes could help identify high-risk patients and inform postoperative management strategies.

Inclusion Criteria:

•Hospitalized older (≥ 65 years) patients underwent non-cardiac surgery

Exclusion Criteria:

• Without preoperative Hcy data (n= 44115)
• Neurosurgery (n= 3343)
• Kidney or renal artery surgery (n= 2478)
• Chronic kidney disease (n=577)

An observational study using data from the First Medical Center of Chinese PLA General Hospital, an electronic medical record-based data set of 29156 older patients (≥ 65 years) who had surgery between January 2014 to December 2023