Delirium Bibliography

Reference Information

Title

Higher serum PGE2 is a predicative biomarker for postoperative delirium following elective orthopedic surgery in elderly patients

Authors

Mao, M. Wang, L. Y. Zhu, L. Y. Wang, F. Ding, Y. Tong, J. H. Sun, J. Sun, Q. Ji, M. H.

Year

2022

Journal

BMC Geriatr

Abstract

BACKGROUND: Postoperative delirium (POD), one of the most common complications following major surgery, imposes a heavy burden on patients and society. The objective of this exploratory study was to conduct a secondary analysis to identify whether there exist novel and reliable serum biomarkers for the prediction of POD. METHODS: A total of 131 adult patients (≥ 65 years) undergoing lower extremity orthopedic surgery with were enrolled in this study. Cognitive function was assessed preoperatively with Mini-Mental State Examination (MMSE). Delirium was diagnosed according to the Confusion Assessment Method (CAM) criteria on preoperative day and postoperative days 1-3. The preoperative serum levels of a panel of 16 biochemical parameters were measured by ELISA. RESULTS: Thirty-five patients developed POD, with an incidence of 26.7%. Patients in POD group were older (P = 0.001) and had lower preoperative MMSE scores (P = 0.001). Preoperative serum levels of prostaglandin E2 (PGE2, P < 0.001), S100β (P < 0.001), glial fibrillary acidic protein (P < 0.001) and neurofilament light (P = 0.002) in POD group were significantly increased. Logistic regression analysis showed that advanced age (OR = 1.144, 95%CI: 1.008 ~ 1.298, P = 0.037), higher serum neurofilament light (OR = 1.003, 95%CI: 1.000 ~ 1.005, P = 0.036) and PGE2 (OR = 1.031, 95%CI: 1.018 ~ 1.044, P < 0.001) levels were associated with the development of POD. In addition, serum level of PGE2 yielded an area under the ROC curve (AUC) of 0.897 to predict POD (P < 0.001), with a sensitivity of 80% and a specificity of 83.3%. CONCLUSIONS: Our study showed that higher preoperative serum PGE2 level might be a biomarker to predict the occurrence of POD in elderly patients undergoing elective orthopedic surgery. TRIAL REGISTRATION: NCT03792373 www. CLINICALTRIALS: gov .

PMID

35982410

Keywords

Aged
Biomarkers
*Delirium/diagnosis/epidemiology/etiology
Dinoprostone
Humans
*Orthopedic Procedures/adverse effects
Postoperative Complications/diagnosis/epidemiology/etiology
Prospective Studies
Risk Factors
Biomarker
Orthopedic surgery
Pge2
Postoperative delirium

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