Association Between Plasma Amyloid‐Beta 42 Ratio and Postoperative Delirium in Elderly Patients Undergoing Major Abdominal Surgery: Secondary Analysis of a Randomized Controlled Trial

作者：Qianqian Fan, Yonghui Wang, Zhihong Lu, Lini Wang, Xue Yang, Ziyu Zheng, Hailong Dong, Lize Xiong, Chong Lei · 发表于：Brain and Behavior · 年份：2025 · DOI：10.1002/brb3.70501 · 被引用次数：5 · 研究领域：Intensive Care Unit Cognitive Disorders、Dementia and Cognitive Impairment Research、Traumatic Brain Injury and Neurovascular Disturbances

INTRODUCTION: Cerebrospinal fluid Aβ42 has been proposed as a potential indicator for cerebral β-amyloidosis and may be involved in the pathophysiology of delirium. Whether perioperative plasma Aβ42 alternation is associated with postoperative delirium risk among elderly patients remains unknown. METHODS: This was a secondary analysis of a randomized controlled trial evaluating the effects of acupuncture (intervention) compared to standard care (control) on the incidence of delirium in patients undergoing major abdominal surgery. Participants with blood samples collected were included in this cohort study. The exposure variable was the Aβ42 ratio, calculated with the plasma Aβ42 level immediately after surgery divided by the preoperative plasma Aβ42 level. The primary endpoint was the occurrence of delirium within the first 7 days following surgery or until hospital discharge, whichever happened first, evaluated using either the Confusion Assessment Method or the Confusion Assessment Method-intensive care unit for intubated patients. Delirium severity was a secondary outcome assessed by the Memorial Delirium Assessment Scale. The logistic regression models and a restricted cubic spline were performed to examine the association between the Aβ42 ratio and delirium incidence, with receiver operating characteristic curve (ROC) analysis for diagnostic power. The mediation effects of the matrix metalloproteinase-9 ratio were further explored by causal mediation analysis. The linear...