Preoperative cerebrospinal fluid biomarkers may be associated with postoperative delirium in patients undergoing knee/hip arthroplasty: the PNDABLE study

作者：Yanan Lin, Nan‐Nan Yu, Xu Lin, Xiyuan Deng, Fanghao Liu, He Tao, Rui Dong, Bin Wang, Yanlin Bi · 发表于：BMC Geriatrics · 年份：2023 · DOI：10.1186/s12877-023-03943-w · 被引用次数：13 · 研究领域：Intensive Care Unit Cognitive Disorders、Traumatic Brain Injury and Neurovascular Disturbances、S100 Proteins and Annexins

Abstract Background In the global aging population, the incidence of postoperative delirium (POD) is increasing. Therefore, finding its effective predictive tools becomes crucial. We aimed to identify potential Cerebrospinal fluid (CSF)biomarkers for POD. Methods A total of 825 patients undergoing knee/hip arthroplasty under combined spinal-epidural anesthesia were selected. The patients were aged 40 to 90 years with American Society of Anesthesiologists physical status I~II. The Mini-Mental State Examination was completed 1 day before the operation. CSF was extracted after successful spinal-epidural combined puncture, and α-synuclein (α-syn), amyloid beta 40 (Aβ 40 ), amyloid beta 42 (Aβ 42 ), t-Tau, phosphorylated Tau (p-Tau), progranulin (PGRN) and soluble triggering receptor expressed on myeloid cells 2 (sTREM2) in the CSF were measured by enzyme-linked immunosorbent assays (ELISA). The patient’s operation time, anesthesia time, intraoperative blood loss and fluid input were also recorded. After the operation, the occurrence rate and severity of POD were determined by the Confusion Assessment Method and the Memorial Delirium Assessment Scale (MDAS), respectively. Patients were categorized into POD group and non-POD group. Logistic regression analysis was performed on the indicators with statistically significant differences, and the area under the ROC curve (AUC) was used to estimate the predictive accuracy of the biomarkers for POD. Results A total of 92 patients develop...