The Role of Stress Hyperglycemia on Delirium Onset

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(2), P. 407 - 407

Published: Jan. 10, 2025

Delirium is an acute neuropsychiatric syndrome that recognizes one or more underlying causal medical conditions. Stress hyperglycemia usually refers to transient associated with stress conditions such as stroke, myocardial infarction, and major surgery. Both delirium share common pathways, activation of inflammation. has been negative outcomes, recent studies suggested there increased risk onset in patients hyperglycemia. The purpose this review illustrate the relationship between delirium. Initially, we role diabetes on onset, summarize criteria used for diagnosis hyperglycemia, discuss impact outcome, focus evidence about

Language: Английский

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Linear association between high-sensitivity C-reactive protein and postoperative delirium after general anesthesia: a cross-sectional study

Frontiers in Neurology, Journal Year: 2025, Volume and Issue: 16

Published: Jan. 31, 2025

To investigate the association between high-sensitivity C-reactive protein (Hs-CRP) levels and risk of postoperative delirium (POD) following general anesthesia. This retrospective cross-sectional study included 644 patients who underwent Univariate multivariate logistic regression analyses were performed to evaluate relationship Hs-CRP POD, with subgroup used assess stratified associations. Receiver operator characteristic (ROC) curve analysis was employed predictive efficacy for POD. Restricted cubic spline (RCS) conducted explore linear log-transformed (Log10Hs-CRP) POD risk. The total population consisted individuals a mean age 64.02 ± 13.20 years, 506 (78.60%) whom male, 114 (17.7%) had Compared lower group, in higher group exhibited age, heart rate, white blood cell count, urea nitrogen, creatinine, uric acid, fasting glucose, hemoglobin A1c, fibrinogen, D-dimer, prevalence CKD, but hemoglobin, high-density lipoprotein cholesterol, albumin estimated glomerular filtration rate. Additionally, (24.7% vs. 9.5%, p < 0.001). Multivariate confirmed that elevated its forms (Log10Hs-CRP, standardized Hs-CRP, group) consistently increased across all adjusted models (p 0.05). Stratified further highlighted significant associations specific subgroups, notably aged ≥65 female patients, those or without hypertension, diabetes, stroke history, chronic kidney disease ROC demonstrated ability overall (AUC = 0.646), as well male 0.644) 0.654). RCS indicated positive Log10Hs-CRP 0.003, nonlinear 0.896). Elevated are significantly associated an

Language: Английский

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Clinical biomarkers of perioperative neurocognitive disorder: initiation and recommendation

Science China Life Sciences, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 22, 2025

Language: Английский

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Cytokines and inflammatory biomarkers and their association with post-operative delirium: a meta-analysis and systematic review

Scientific Reports, Journal Year: 2025, Volume and Issue: 15(1)

Published: March 6, 2025

Delirium is a prevalent cognitive disorder among older patients and common phenomenon following major surgical procedures. This study aimed to identify the significant proteomic biomarkers examine their association with postoperative delirium (POD). Four electronic databases were used published articles between 1st January 2000 31st December 2023. Among included 40 studies, meta-analysis investigated 13 potential cytokines inflammatory biomarker proteins linked delirium. The Hedge's g standardized mean difference (SMD) was applied calculate effect size, 95% confidence intervals (CIs), under fixed or random model based on heterogeneity index of I2. Patients POD exhibited significantly higher elevated levels IL-6 (SMD = 1.45), CRP 1.26), GFAP 1.15), IL-1B 0.95), IL-10 0.57), IL-8 0.56), MCP-1 0.39), NFL 0.44), suggesting that these may play an inevitable role in delirium-associated response, development progression Conversely, reduction IGF-1 protein level - 0.24) also associated POD, vulnerability paves way for future research at early diagnosis, personalized treatment, novel therapeutic strategies manage effectively.

Language: Английский

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The relationship between preoperative serum indirect bilirubin and postoperative delirium in geriatric patients undergoing joint replacement

PLoS ONE, Journal Year: 2025, Volume and Issue: 20(3), P. e0320719 - e0320719

Published: March 27, 2025

Background Postoperative delirium (POD) is one of the most common complications in geriatric patients following surgery. Physiological concentration bilirubin possesses anti-inflammatory, antioxidant and neuroprotective effects, which are important protective mechanisms against POD. This study aimed to explore relationship between preoperative serum POD undergoing joint replacement. Methods Geriatric who underwent hip or knee replacement surgery under intrathecal anesthesia were included. These had American Society Anesthesiologists (ASA) grades I III. The with a history psychiatric neurological disorders, infectious diseases sepsis, hemolytic anemia, liver diseases, performed general combined anesthesia, insufficient surgical information excluded. Patients’ age, gender, weight, height, ASA classification, function within week before surgery, Mini–Mental State Examination (MMSE) scores, type, dosage medications, intraoperative bleeding volume, postoperative average numeric rating scale (NRS) pain occurrence Delirium Rating Scale–Revised–98 (DRS–R–98) scores for collected. Results A total 269 eligible inclusion study, 23.05% (62/207) exhibiting Patients exhibited higher age lower (TBIL) indirect (IBIL) MMSE (all p < 0.05). Univariate logistic regression analysis showed that above variables correlated Multivariate revealed was risk factor ( 0.001, OR = 1.14, 95% CI [1.07 – 1.21]), while weight 0.041, 0.96, [0.92 0.99]), IBIL levels 0.012, 0.65, [0.47–0.91]) 0.84, [0.78 0.91]) served as factors receiver operating characteristic (ROC) curve analysis. estimated cutoff value predicting 6.65 μmol/L, area (AUC) 0.63. below μmol/L incidence Conclusion Low predictor

Language: Английский

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Association of peripheral B cells and delirium: combined single-cell sequencing and Mendelian randomization analysis

Frontiers in Neurology, Journal Year: 2024, Volume and Issue: 15

Published: Feb. 6, 2024

Background Delirium seriously affects the prognosis of patients and greatly reduces ability to work live. Peripheral inflammatory events may contribute development delirium, mechanism which is still unclear. There a lack effective diagnostic treatments for delirium in clinical practice. The study aims investigate alterations peripheral immune cell subsets under stress explore causal associations with delirium. Methods Single-cell transcriptional sequencing data human blood mononuclear cells (PBMC) before after lipopolysaccharide (LPS) intervention were processed by Seurat package R software. PBMC cellular markers defined downscaling clustering Harmony algorithm identify characteristic context stress. Subsequently, two-sample Mendelian randomization (MR) was used these inflammation-related their molecular phenotypes Based on publicly available genetic data, incorporated 70 PBMC-associated traits, including 8 types circulating cells, 33 B phenotypes, 13 T subsets, 16 cell-associated cytokines. results also validated robustness, heterogeneity, horizontal pleiotropy. Results Under LPS-induced stress, monocytes, dendritic showed significant activation quantitative changes. Of these, only lymphocyte counts causally associated risk. This risk link seen TNF pathway. Further studies revealed that this association be related unswitched memory CD27 expressed cells. Annotation screened SNPs polymorphisms CD40 annotated rs25680 rs9883798, respectively. functions key genes regulation responses, differentiation, proliferation, intercellular interactions. Conclusion present potential possibility cell, subset, TNF-related molecules involved due inflammation, can provide clues further investigation prevention treatment strategies.

Language: Английский

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Preoperative cognitive function as a risk factor of postoperative delirium in cancer surgeries: A systematic review and meta‐analysis

Journal of Surgical Oncology, Journal Year: 2024, Volume and Issue: 130(2), P. 222 - 240

Published: June 12, 2024

Postoperative delirium (POD) after cancer surgeries can be a result of chemo brain, anesthesia, surgery duration, and preoperative cognitive impairment. Although older age dysfunction were reported to increase the risk POD in noncardiac surgery, role function development all types is not clear. This study aimed determine relationship between likelihood surgeries. used three main online databases followed PRISMA guidelines. English language original articles that examined before solid tumor assessed patients for postoperative included. We employed random effect meta-analysis method. The overall incidence ranged from 8.7% 50.9%. confusion assessment method was most common tool assess delirium. Mini-mental state evaluation (MMSE), Mini-cog, Montreal tools function. pooled (total observation = 4676) effects SMD estimated at -0.84 (95% confidence interval [CI]: -1.30 -0.31), indicating lower MMSE scores are associated with higher POD. 2668) OR 5.17 CI: 2.51 -10.63), significantly predict occurrence In conclusion, an independent significant predictor

Language: Английский

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Postoperative Delirium and Cognitive Dysfunction After Cardiac Surgery: The Role of Inflammation and Clinical Risk Factors

Diagnostics, Journal Year: 2025, Volume and Issue: 15(7), P. 844 - 844

Published: March 26, 2025

Background/Objectives: Postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) are prevalent neurological complications following cardiac surgery, significantly affecting patient recovery long-term outcomes, including increased risk of persistent impairment, functional decline, mortality. Understanding the underlying mechanisms factors for POD/POCD is crucial improving perioperative management. This study aimed to investigate relationship between systemic inflammation, assessed through inflammatory markers, occurrence POD POCD in patients undergoing surgery. Methods: We prospectively enrolled 88 aged 18-79 years open-heart Patients with preoperative impairment or high surgical (based on EuroSCORE SOFA scores) were excluded focus impact inflammation a relatively unselected cohort. responses (CRP, NLR, IL-6, IL-17A, SII, SIRI) measured, (CAM-ICU) (neuropsychological testing) during hospitalization at 3 months follow-up. Statistical comparisons performed who developed those did not. Results: was confirmed across cohort, significant increases CRP, SIRI. While correlational analyses changes individual markers not statistically entire exhibited higher levels IL-6 NLR 48 h postoperatively (p < 0.05). Established clinical associated included older age, prolonged cardiopulmonary bypass (CPB) duration, extended mechanical ventilation, vasopressor support blood transfusion, renal dysfunction, elevated creatine kinase (CK) lactate dehydrogenase (LDH) Ejection fraction (EF) 45% atrial fibrillation (AF) also more group. Conclusions: Our findings emphasize role response, particularly conjunction established factors, development after levels, readily measurable cost-effective may contribute identifying risk. Comprehensive management strategies targeting modifiable organ function mitigating outcomes this vulnerable population.

Language: Английский

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2025 American Society of Anesthesiologists Practice Advisory for Perioperative Care of Older Adults Scheduled for Inpatient Surgery

Anesthesiology, Journal Year: 2024, Volume and Issue: 142(1), P. 22 - 51

Published: Dec. 6, 2024

This advisory provides evidence-based recommendations on the management of older adults undergoing inpatient surgery. The focuses aspects preoperative, intraoperative, and postoperative care specific relevance to (i.e., 65 yr or older), it addresses approaches minimizing complications anesthesia common among patients.

Language: Английский

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Postoperative Delirium and Dementia in Patients Undergoing Cardiac Surgery: A Review of Randomized Controlled Trials

Galen Medical Journal, Journal Year: 2023, Volume and Issue: 12

Published: Aug. 23, 2023

Delirium and dementia are considered to be the most significant postoperative neurocognitive complications in patients undergoing cardiac surgery, particularly those aged 60 years older, which reduces post-surgery quality of life, prolongs hospitalization, increases costs, elevated rates mortality. Nevertheless, etiology, risk factors, predictive biomarkers, have not been well elucidated particularly, with unmanifested underline cognitive impairments. The present study aimed review findings on factors increasing incidence, biomarkers delirium after describe suggested pharmacological non-pharmacological interventions.

Language: Английский

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