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Edward R Marcantonio - One of the best experts on this subject based on the ideXlab platform.
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AN INFLAMMATORY SIGNATURE OF Postoperative Delirium
Innovation in Aging, 2020Co-Authors: Sarinnapha Vasunilashorn, Simon T. Dillon, Bridget Tripp, Sharon K. Inouye, Towia A. Libermann, Edward R MarcantonioAbstract:Abstract Delirium is a common, morbid, and costly geriatric syndrome, yet its pathophysiology remains poorly understood. In a nested matched case-control study within the Successful Aging after Elective Surgery (SAGES) study, a cohort of adults age ≥70 without dementia undergoing major non-cardiac surgery, we previously identified inflammatory proteins to be associated with Delirium. Using the entire SAGES cohort, the current study examines the independent associations of these inflammatory proteins with Postoperative Delirium. Plasma was collected preoperatively (PREOP) and on Postoperative day 2 (POD2). Neuroinflammatory marker chitinase-3-like protein [CHI3l1 or YKL-40]; PREOP and POD2) and systemic inflammatory markers interleukin [IL]-6 (POD2 only) and C-reactive protein (CRP; PREOP and POD2) were measured using enzyme-linked immunosorbent assays. Generalized linear models were used to determine the independent (multivariable) associations between the inflammatory markers, measured in sample-based quartiles (Q). All models adjusted for age, sex, baseline cognition, surgery type, Charlson comorbidity index, and medical complications. Among the 555 patients (mean age 77 years, standard deviation, SD 5.2), 58% were female and 86% underwent orthopedic surgeries. Postoperative Delirium occurred in 24%. High YKL-40 PREOP and IL-6 at POD2 (Q4 vs. Q1) were significantly associated with an increased risk of Delirium: relative risk (RR) [95% confidence interval (CI)] 2.2[1.1-4.4] and 2.7[1.3-5.7], respectively. CRP (PREOP and POD2) was not significantly associated with Delirium (p=0.37 and p=0.73, respectively). This work underscores the importance of inflammation (YKL-40 and IL-6) in the pathophysiology of Postoperative Delirium.
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Postoperative Delirium Is Associated with Long-term Decline in Activities of Daily Living.
Anesthesiology, 2019Co-Authors: Cheng Li, Hui Zheng, Yujie Wu, Yupeng Chen, Hailin Zheng, Edward R MarcantonioAbstract:Postoperative Delirium is one of the most common complications in the elderly surgical population. However, its long-term outcomes remain largely to be determined. Therefore a prospective cohort study was conducted to determine the association between Postoperative Delirium and long-term decline in activities of daily living and Postoperative mortality. The hypothesis in the present study was that Postoperative Delirium was associated with a greater decline in activities of daily living and higher mortality within 24 to 36 months after anesthesia and surgery. The participants (at least 65 yr old) having the surgeries of (1) proximal femoral nail, (2) hip replacement, or (3) open reduction and internal fixation under general anesthesia were enrolled. The Confusion Assessment Method algorithm was administered to diagnose Delirium before and on the first, second, and fourth days after the surgery. Activities of daily living were evaluated by using the Chinese version of the activities of daily living scale (range, 14 to 56 points), and preoperative cognitive function was assessed by using the Chinese Mini-Mental State Examination (range, 0 to 30 points). The follow-up assessments, including activities of daily living and mortality, were conducted between 24 and 36 months after anesthesia and surgery. Of 130 participants (80 ± 6 yr, 24% male), 34 (26%) developed Postoperative Delirium during the hospitalization. There were 32% of the participants who were lost to follow-up, resulting in 88 participants who were finally included in the data analysis. The participants with Postoperative Delirium had a greater decline in activities of daily living (16 ± 15 vs. 9 ± 15, P = 0.037) and higher 36-month mortality (8 of 28, 29% vs. 7 of 75, 9%; P = 0.009) as compared with the participants without Postoperative Delirium. Postoperative Delirium was associated with long-term detrimental outcomes, including greater decline in activities of daily living and a higher rate of Postoperative mortality.
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different mmse score is associated with Postoperative Delirium in young old and old old adults
PLOS ONE, 2015Co-Authors: Yujie Wu, Edward R Marcantonio, Meijuan Wang, Cheng Li, Guodong Li, Yuan ShenAbstract:Background Postoperative Delirium is one of the most common Postoperative complications in geriatric patients. Mini-mental state examination (MMSE) assesses cognitive function in patients and is associated with Postoperative Delirium. However, whether there is an age-dependent relationship between preoperative MMSE score and Postoperative Delirium remains unknown.
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does apolipoprotein e genotype increase risk of Postoperative Delirium
American Journal of Geriatric Psychiatry, 2015Co-Authors: Sarinnapha Vasunilashorn, Sharon K. Inouye, Cyrus M Kosar, Tamara G Fong, Richard N Jones, Edward R MarcantonioAbstract:Objective To determine whether apolipoprotein E (ApoE) is associated with Postoperative Delirium incidence, severity, and duration in older patients free of dementia at baseline. Methods The authors examined 557 nondemented patients aged 70 years or older undergoing major noncardiac surgery enrolled in the Successful Aging after Elective Surgery Study. Three ApoE measures were considered: e2, e4 carriers versus noncarriers, and a three-category ApoE measure. Delirium was determined using the Confusion Assessment Method (CAM) and chart review. We used generalized linear models to estimate the association between ApoE and Delirium incidence, severity (peak CAM Severity [CAM-S] score), and days. Results ApoE e2 and e4 was present in 15% and 19%, respectively, and Postoperative Delirium occurred in 24%. Among patients with Delirium, the mean peak CAM-S score was 8.0 (standard deviation: 4), with most patients experiencing 1 or 2 Delirium days (51% or 28%, respectively). After adjusting for age, sex, surgical procedure, and preoperative cognitive function, ApoE e4 and e2 carrier status were not associated with Postoperative Delirium: RR for e4 = 1.0, 95% CI: 0.7–1.5 and RR for e2 = 0.9, 95% CI: 0.6–1.4. No association between ApoE and Delirium severity or number of Delirium days was observed. Conclusion In older surgery patients free of dementia, our findings do not support the hypothesis that the ApoE genotype does not confer either risk or protection in Postoperative Delirium incidence, severity, or duration. Thus, an important genetic risk factor for Alzheimer disease does not affect risk of Delirium.
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preoperative cerebrospinal fluid β amyloid tau ratio and Postoperative Delirium
Annals of clinical and translational neurology, 2014Co-Authors: Celeste A Swain, Sarah A P Ward, Hui Zheng, Yuanlin Dong, Neelakantan Sunder, Dennis W Burke, Diana Escobar, Yiying Zhang, Edward R MarcantonioAbstract:Objective: The neuropathogenesis of Postoperative Delirium remains unknown. Low cerebrospinal fluid (CSF) b-amyloid protein (Ab) and high CSF Tau levels are associated with Alzheimer’s disease. We, therefore, assessed whether lower preoperative CSF Ab/Tau ratio was associated with higher incidence and greater severity of Postoperative Delirium. Methods: One hundred and fifty-three participants (71 5 years, 53% men) who had total hip/knee replacement under spinal anesthesia were enrolled. CSF was obtained during initiation of spinal anesthesia. The incidence and severity of Postoperative Delirium were determined by Confusion Assessment Method (CAM) and Memorial Delirium Assessment Scale (MDAS) on Postoperative day 1 and 2. Ab40, Ab42, and Tau levels in the CSF were measured by enzyme-linked immunosorbent assay. The relationships among these variables were determined, adjusting for age and gender. Results: Participants in the lowest quartile of preoperative CSF Ab40/Tau and Ab42/Tau ratio had higher incidence (32% vs. 17%, P = 0.0482) and greater symptom severity of Postoperative Delirium (Ab40/Tau ratio: 4 vs. 3, P = 0.034; Ab42/Tau ratio: 4 vs. 3, P = 0.062, the median of the highest MDAS score) as compared to the combination of the rest of the quartiles. The preoperative CSF Ab40/Tau or Ab42/Tau ratio was inversely associated with MDAS score (Ab40/Tau ratio: 0.12 0.05, P = 0.014, adj. 0.12 0.05, P = 0.018; Ab42/Tau ratio: 0.65 0.26, P = 0.013, adj. 0.62 0.27, P = 0.022). Interpretation: Lower CSF Ab/Tau ratio could be associated with Postoperative Delirium, pending confirmation of our preliminary results in further studies. These findings suggest potential roles of Ab and/or Tau in Postoperative Delirium neuropathogenesis.
Jacqueline M. Leung - One of the best experts on this subject based on the ideXlab platform.
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Processed Electroencephalogram Monitoring and Postoperative Delirium: A Systematic Review and Meta-analysis.
Anesthesiology, 2018Co-Authors: Kristen K. Mackenzie, Laura P. Sands, Angelitta M. Britt-spells, Jacqueline M. LeungAbstract:What We Already Know about This TopicUp to 20% of patients undergoing major surgery experience Postoperative Delirium or cognitive dysfunctionIntraoperative management strategies to reduce the risk of Postoperative Delirium remain unclearWhat This Article Tells Us That Is NewThe heterogeneity of cog
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Preoperative Sleep Disruption and Postoperative Delirium.
Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2015Co-Authors: Jacqueline M. Leung, Laura P. Sands, Stacey Newman, Gabriela MecklerAbstract:To describe preoperative and Postoperative sleep disruption and its relationship to Postoperative Delirium.Prospective cohort study with 6 time points (3 nights pre-hospitalization and 3 nights post-surgery).University medical center.The sample consisted of 50 English-speaking patients ≥ 40 years of age scheduled for major non-cardiac surgery, with an anticipated hospital stay ≥ 3 days.None.Sleep was measured before and after surgery for a total of 6 days using a wrist actigraph to quantify movement in a continuous fashion. Postoperative Delirium was measured by a structured interview using the Confusion Assessment Method. Sleep variables for patients with (n = 7) and without (n = 43) Postoperative Delirium were compared using the unpaired Student t-tests or χ(2) tests. Repeated measures analysis of variance for the 6 days was used to examine within-subject changes over time and between group differences. The mean age of the patients was 66 ± 11 years (range 43-91 years), and it was not associated with sleep variables or Postoperative Delirium. The incidence of Postoperative Delirium observed during any of the 3 Postoperative days was 14%. For the 7 patients who subsequently developed Postoperative Delirium, wake after sleep onset (WASO) as a percentage of total sleep time was significantly higher (44% ± 22%) during the night before surgery compared to the patients who did not subsequently developed Delirium (21% ± 20%, p = 0.012). This sleep disruption continued Postoperatively, and to a greater extent, for the first 2 nights after surgery. Patients with WASO < 10% did not experience Postoperative Delirium. Self-reported sleep disturbance did not differ between patients with vs. without Postoperative Delirium.In this pilot study of adults over 40 years of age, sleep disruption was more severe before surgery in the patients who experienced Postoperative Delirium. A future larger study is necessary to confirm our results and determine if poor sleep is associated with Delirium in larger samples and what specific sleep problems best predict Postoperative Delirium in older surgical patients.
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Does using a femoral nerve block for total knee replacement decrease Postoperative Delirium
BMC Anesthesiology, 2012Co-Authors: Sakura Kinjo, Laura P. Sands, Kevin J. Bozic, Jacqueline M. LeungAbstract:Background: The effect of peripheral nerve blocks on Postoperative Delirium in older patients has not been studied. Peripheral nerve blocks may reduce the incidence of Postoperative opioid use and its side effects such as Delirium via opioid-sparing effect. Methods: A prospective cohort study was conducted in patients who underwent total knee replacement. Baseline cognitive function was assessed using the Telephone Interview for Cognitive Status. Postoperative Delirium was measured using the Confusion Assessment Method Postoperatively. Incidence of Postoperative Delirium was compared in two Postoperative management groups: femoral nerve block ± patient-controlled analgesia and patient-controlled analgesia only. In addition, pain levels (using numeric rating scales) and opioid use were compared in two groups. Results: 85 patients were studied. The overall incidence of Postoperative Delirium either on Postoperative day one or day two was 48.1%. Incidence of Postoperative Delirium in the femoral nerve block group was lower than patient controlled analgesia only group (25% vs. 61%, P = 0.002). However, there was no significant difference between the groups with respect to Postoperative pain level or the amount of intravenous opioid use. Conclusions: Femoral nerve block reduces the incidence of Postoperative Delirium. These results suggest that a larger randomized control trial is necessary to confirm these preliminary findings.
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preoperative frailty in older surgical patients is associated with early Postoperative Delirium
Anesthesia & Analgesia, 2011Co-Authors: Jacqueline M. Leung, Tiffany L Tsai, Laura P. SandsAbstract:Among older noncardiac surgical patients, we investigated whether preoperative frailty provides information about the development of Postoperative Delirium that is in addition to traditional geriatric risk factors. One-third of patients had a frailty score ≥ 3, which is considered ‘frail’ in others’ research. Twenty-five percent of patients developed Postoperative Delirium, which was measured using the Confusion Assessment Method. Multivariable logistic regression showed that age, activities of daily living dependence, independent activities of daily living dependence and cognitive functioning did not contribute significantly to the prediction of Postoperative Delirium. Only preoperative symptoms of depression (OR=1.42; 95% CI=1.06–1.91; p=0.018) and the frailty score (OR=1.84; 95% CI=1.07–3.1; p=0.028) were independently associated with the development of Postoperative Delirium.
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Does Postoperative Delirium Limit the Use of Patient-controlled Analgesia in Older Surgical Patients?
Anesthesiology, 2009Co-Authors: Jacqueline M. Leung, Laura P. Sands, Sakura Kinjo, Sudeshna Paul, Tim Joseph, Tiffany L TsaiAbstract:Background Postoperative pain was an independent predictor of Postoperative Delirium. Whether Postoperative Delirium limits patient controlled analgesia (PCA) use has not been determined.
Laura P. Sands - One of the best experts on this subject based on the ideXlab platform.
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Processed Electroencephalogram Monitoring and Postoperative Delirium: A Systematic Review and Meta-analysis.
Anesthesiology, 2018Co-Authors: Kristen K. Mackenzie, Laura P. Sands, Angelitta M. Britt-spells, Jacqueline M. LeungAbstract:What We Already Know about This TopicUp to 20% of patients undergoing major surgery experience Postoperative Delirium or cognitive dysfunctionIntraoperative management strategies to reduce the risk of Postoperative Delirium remain unclearWhat This Article Tells Us That Is NewThe heterogeneity of cog
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Preoperative Sleep Disruption and Postoperative Delirium.
Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2015Co-Authors: Jacqueline M. Leung, Laura P. Sands, Stacey Newman, Gabriela MecklerAbstract:To describe preoperative and Postoperative sleep disruption and its relationship to Postoperative Delirium.Prospective cohort study with 6 time points (3 nights pre-hospitalization and 3 nights post-surgery).University medical center.The sample consisted of 50 English-speaking patients ≥ 40 years of age scheduled for major non-cardiac surgery, with an anticipated hospital stay ≥ 3 days.None.Sleep was measured before and after surgery for a total of 6 days using a wrist actigraph to quantify movement in a continuous fashion. Postoperative Delirium was measured by a structured interview using the Confusion Assessment Method. Sleep variables for patients with (n = 7) and without (n = 43) Postoperative Delirium were compared using the unpaired Student t-tests or χ(2) tests. Repeated measures analysis of variance for the 6 days was used to examine within-subject changes over time and between group differences. The mean age of the patients was 66 ± 11 years (range 43-91 years), and it was not associated with sleep variables or Postoperative Delirium. The incidence of Postoperative Delirium observed during any of the 3 Postoperative days was 14%. For the 7 patients who subsequently developed Postoperative Delirium, wake after sleep onset (WASO) as a percentage of total sleep time was significantly higher (44% ± 22%) during the night before surgery compared to the patients who did not subsequently developed Delirium (21% ± 20%, p = 0.012). This sleep disruption continued Postoperatively, and to a greater extent, for the first 2 nights after surgery. Patients with WASO < 10% did not experience Postoperative Delirium. Self-reported sleep disturbance did not differ between patients with vs. without Postoperative Delirium.In this pilot study of adults over 40 years of age, sleep disruption was more severe before surgery in the patients who experienced Postoperative Delirium. A future larger study is necessary to confirm our results and determine if poor sleep is associated with Delirium in larger samples and what specific sleep problems best predict Postoperative Delirium in older surgical patients.
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Does using a femoral nerve block for total knee replacement decrease Postoperative Delirium
BMC Anesthesiology, 2012Co-Authors: Sakura Kinjo, Laura P. Sands, Kevin J. Bozic, Jacqueline M. LeungAbstract:Background: The effect of peripheral nerve blocks on Postoperative Delirium in older patients has not been studied. Peripheral nerve blocks may reduce the incidence of Postoperative opioid use and its side effects such as Delirium via opioid-sparing effect. Methods: A prospective cohort study was conducted in patients who underwent total knee replacement. Baseline cognitive function was assessed using the Telephone Interview for Cognitive Status. Postoperative Delirium was measured using the Confusion Assessment Method Postoperatively. Incidence of Postoperative Delirium was compared in two Postoperative management groups: femoral nerve block ± patient-controlled analgesia and patient-controlled analgesia only. In addition, pain levels (using numeric rating scales) and opioid use were compared in two groups. Results: 85 patients were studied. The overall incidence of Postoperative Delirium either on Postoperative day one or day two was 48.1%. Incidence of Postoperative Delirium in the femoral nerve block group was lower than patient controlled analgesia only group (25% vs. 61%, P = 0.002). However, there was no significant difference between the groups with respect to Postoperative pain level or the amount of intravenous opioid use. Conclusions: Femoral nerve block reduces the incidence of Postoperative Delirium. These results suggest that a larger randomized control trial is necessary to confirm these preliminary findings.
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preoperative frailty in older surgical patients is associated with early Postoperative Delirium
Anesthesia & Analgesia, 2011Co-Authors: Jacqueline M. Leung, Tiffany L Tsai, Laura P. SandsAbstract:Among older noncardiac surgical patients, we investigated whether preoperative frailty provides information about the development of Postoperative Delirium that is in addition to traditional geriatric risk factors. One-third of patients had a frailty score ≥ 3, which is considered ‘frail’ in others’ research. Twenty-five percent of patients developed Postoperative Delirium, which was measured using the Confusion Assessment Method. Multivariable logistic regression showed that age, activities of daily living dependence, independent activities of daily living dependence and cognitive functioning did not contribute significantly to the prediction of Postoperative Delirium. Only preoperative symptoms of depression (OR=1.42; 95% CI=1.06–1.91; p=0.018) and the frailty score (OR=1.84; 95% CI=1.07–3.1; p=0.028) were independently associated with the development of Postoperative Delirium.
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Does Postoperative Delirium Limit the Use of Patient-controlled Analgesia in Older Surgical Patients?
Anesthesiology, 2009Co-Authors: Jacqueline M. Leung, Laura P. Sands, Sakura Kinjo, Sudeshna Paul, Tim Joseph, Tiffany L TsaiAbstract:Background Postoperative pain was an independent predictor of Postoperative Delirium. Whether Postoperative Delirium limits patient controlled analgesia (PCA) use has not been determined.
Babar A Khan - One of the best experts on this subject based on the ideXlab platform.
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perioperative risk factors for Postoperative Delirium in patients undergoing esophagectomy
The Annals of Thoracic Surgery, 2019Co-Authors: Mikita Fuchita, Sikandar H Khan, Anthony J Perkins, Sophia Wang, Kenneth A Kesler, Babar A KhanAbstract:Background Postoperative Delirium affects up to 50% of patients undergoing esophagectomy and is associated with negative outcomes. The perioperative risk factors for Delirium in this population are not well understood. We conducted this study to assess perioperative risk factors for Postoperative Delirium among esophagectomy patients. Methods We performed a secondary data analysis of patients enrolled in a randomized controlled trial evaluating the efficacy of haloperidol prophylaxis Postoperatively in reducing Delirium among esophagectomy patients. Postoperative Delirium was assessed twice daily using the Confusion Assessment Method for the ICU. Univariate and logistic regression analyses were performed to examine the association between perioperative variables and development of Postoperative Delirium. Results Of 84 consecutive esophagectomy patients, Postoperative Delirium developed in 27 (32%). These patients had higher Acute Physiology and Chronic Health Evaluation II scores (22.1 [SD, 6.5] vs 17.4 [SD, 6.8]; p = 0.003), longer mechanical ventilation days (1.7 [SD, 1.4] days vs 1.0 [SD, 1.1] days; p = 0.001), and longer intensive care unit (ICU) days (5.1 [SD, 2.6] days vs 2.6 [SD, 1.6] days; p Conclusions ICU length of stay was significantly associated with Postoperative Delirium. Other perioperative factors, including duration of procedure, blood loss, and hemoglobin levels, were not significantly associated with Postoperative Delirium.
Celeste A Swain - One of the best experts on this subject based on the ideXlab platform.
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preoperative cerebrospinal fluid β amyloid tau ratio and Postoperative Delirium
Annals of clinical and translational neurology, 2014Co-Authors: Celeste A Swain, Sarah A P Ward, Hui Zheng, Yuanlin Dong, Neelakantan Sunder, Dennis W Burke, Diana Escobar, Yiying Zhang, Edward R MarcantonioAbstract:Objective: The neuropathogenesis of Postoperative Delirium remains unknown. Low cerebrospinal fluid (CSF) b-amyloid protein (Ab) and high CSF Tau levels are associated with Alzheimer’s disease. We, therefore, assessed whether lower preoperative CSF Ab/Tau ratio was associated with higher incidence and greater severity of Postoperative Delirium. Methods: One hundred and fifty-three participants (71 5 years, 53% men) who had total hip/knee replacement under spinal anesthesia were enrolled. CSF was obtained during initiation of spinal anesthesia. The incidence and severity of Postoperative Delirium were determined by Confusion Assessment Method (CAM) and Memorial Delirium Assessment Scale (MDAS) on Postoperative day 1 and 2. Ab40, Ab42, and Tau levels in the CSF were measured by enzyme-linked immunosorbent assay. The relationships among these variables were determined, adjusting for age and gender. Results: Participants in the lowest quartile of preoperative CSF Ab40/Tau and Ab42/Tau ratio had higher incidence (32% vs. 17%, P = 0.0482) and greater symptom severity of Postoperative Delirium (Ab40/Tau ratio: 4 vs. 3, P = 0.034; Ab42/Tau ratio: 4 vs. 3, P = 0.062, the median of the highest MDAS score) as compared to the combination of the rest of the quartiles. The preoperative CSF Ab40/Tau or Ab42/Tau ratio was inversely associated with MDAS score (Ab40/Tau ratio: 0.12 0.05, P = 0.014, adj. 0.12 0.05, P = 0.018; Ab42/Tau ratio: 0.65 0.26, P = 0.013, adj. 0.62 0.27, P = 0.022). Interpretation: Lower CSF Ab/Tau ratio could be associated with Postoperative Delirium, pending confirmation of our preliminary results in further studies. These findings suggest potential roles of Ab and/or Tau in Postoperative Delirium neuropathogenesis.
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Preoperative cerebrospinal fluid β‐Amyloid/Tau ratio and Postoperative Delirium
Annals of clinical and translational neurology, 2014Co-Authors: Celeste A Swain, Sarah A P Ward, Hui Zheng, Yuanlin Dong, Neelakantan Sunder, Dennis W Burke, Diana Escobar, Yiying Zhang, Edward R MarcantonioAbstract:Objective: The neuropathogenesis of Postoperative Delirium remains unknown. Low cerebrospinal fluid (CSF) b-amyloid protein (Ab) and high CSF Tau levels are associated with Alzheimer’s disease. We, therefore, assessed whether lower preoperative CSF Ab/Tau ratio was associated with higher incidence and greater severity of Postoperative Delirium. Methods: One hundred and fifty-three participants (71 5 years, 53% men) who had total hip/knee replacement under spinal anesthesia were enrolled. CSF was obtained during initiation of spinal anesthesia. The incidence and severity of Postoperative Delirium were determined by Confusion Assessment Method (CAM) and Memorial Delirium Assessment Scale (MDAS) on Postoperative day 1 and 2. Ab40, Ab42, and Tau levels in the CSF were measured by enzyme-linked immunosorbent assay. The relationships among these variables were determined, adjusting for age and gender. Results: Participants in the lowest quartile of preoperative CSF Ab40/Tau and Ab42/Tau ratio had higher incidence (32% vs. 17%, P = 0.0482) and greater symptom severity of Postoperative Delirium (Ab40/Tau ratio: 4 vs. 3, P = 0.034; Ab42/Tau ratio: 4 vs. 3, P = 0.062, the median of the highest MDAS score) as compared to the combination of the rest of the quartiles. The preoperative CSF Ab40/Tau or Ab42/Tau ratio was inversely associated with MDAS score (Ab40/Tau ratio: 0.12 0.05, P = 0.014, adj. 0.12 0.05, P = 0.018; Ab42/Tau ratio: 0.65 0.26, P = 0.013, adj. 0.62 0.27, P = 0.022). Interpretation: Lower CSF Ab/Tau ratio could be associated with Postoperative Delirium, pending confirmation of our preliminary results in further studies. These findings suggest potential roles of Ab and/or Tau in Postoperative Delirium neuropathogenesis.