Potential Value of Serum Lipid in the Identication of Postoperative Delirium Undergoing Knee/Hip Arthroplasty: The Perioperative Neurocognitive Disorder and Biomarker Lifestyle Study

作者：Yanan Lin, Xiaoyan Peng, Xu Lin, Xiyuan Deng, Fanghao Liu, He Tao, Rui Dong, Bin Wang, Yanlin Bi · 发表于：Frontiers in Psychiatry · 年份：2022 · DOI：10.3389/fpsyt.2022.870317 · 被引用次数：28 · 研究领域：Intensive Care Unit Cognitive Disorders、Anesthesia and Neurotoxicity Research、Enhanced Recovery After Surgery

Objective We aimed to investigate the relationship between preoperative lipid level and postoperative delirium (POD) and explore whether lipid’s effect on POD is mediated by POD core protein. Methods A total of 635 patients who were planned to undergo knee/hip arthroplasty under combined spinal-epidural anesthesia, regardless of gender, were selected. The patients were aged 40–90 years with American Society of Anesthesiologists physical status I II. The Mini-Mental State Examination (MMSE) was completed 1 day before the operation. Five milliliter elbow venous blood was taken from the patients before anesthesia, and serum levels of total cholesterol (TG), triglyceride (TC), low-density lipoprotein (LDL-C), and high-density lipoprotein (HDL-C) were detected. Cerebrospinal fluid (CSF) was extracted after successful spinal-epidural combined puncture, and amyloid beta 40 (Aβ 40 ), amyloid beta 42 (Aβ 42 ), total Tau (t-Tau), and phosphorylated Tau (p-Tau) in the CSF were measured by enzyme-linked immunosorbent assays (ELISA). After the operation, the occurrence and severity of POD were assessed using the Confusion Assessment Method and the Memorial Delirium Assessment Scale (MDAS), respectively. Patients were categorized into POD group and NPOD group. Logistic regression was used to analyze the relationship between POD and TC, TG, LDL-C, and HDL-C, and the mediating effect was used to analyze the role of POD core proteins in the relationship between lipid and MDAS. We used the rec...