Preoperative homocysteine modifies the association between postoperative C-reactive protein and postoperative delirium

Ma, Xiaoguang; Mei, Xinchun; Tang, Tianyi; Wang, Meijuan; Wei, Xiaoyi; Zheng, Hailin; Cao, Jian; Cody, Kathryn; Xiong, Lei; Marcantonio, Edward R.; Xie, Zhongcong; Shen, Yuan

doi:10.3389/fnagi.2022.963421

Cited by 6 publications

(2 citation statements)

References 45 publications

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“…Interestingly, the present study did not nd the associations between the three gut bacteria and the severity of postoperative delirium in patients, as represented by MDAS scores. However, previous studies show that some biomarkers are only associated with the incidence, not severity, of postoperative delirium in patients 53 .…”

Section: Discussionmentioning

confidence: 89%

The association between gut microbiota and postoperative delirium in patients

Xie¹,

Zhang

Baldyga³

et al. 2023

Preprint

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Postoperative delirium is one of the most common postoperative complications in older patients. Its pathogenesis and biomarkers, however, remain largely undetermined. Majority of human microbiota is gut microbiota and gut microbiota has been shown to regulate brain function. Therefore, this study aimed to determine the association between gut microbiota and postoperative delirium in patients. Of 220 patients (65 years old or older) who had a knee replacement, hip replacement, or laminectomy under general or spinal anesthesia, 86 participants were included in the data analysis. The incidence (primary outcome) and severity of postoperative delirium was assessed for two days. Fecal swabs were collected from participants immediately after surgery. The 16S rRNA gene sequencing was used to assess gut microbiota. Using principal component analyses along with a literature review to identify biologically plausible mechanisms, and three bacterials were studied for their associations with postoperative delirium. Of the 86 participants [age 71.0 (69.0–76.0, 25%-75% percentile of quartile), 53% female], ten (12%) developed postoperative delirium. Postoperative gut bacteria Parabacteroides distasonis (Odds Ratio [OR] 2.13, 95% Confidence Interval (CI): 1.09–4.17, P = 0.026) was associated with postoperative delirium after adjusting for age and sex. The association between delirium and both Prevotella (OR: 0.59, 95% CI: 0.33–1.04, P = 0.067) and Collinsella (OR: 0.57, 95% CI: 0.27–1.24, P = 0.158) did not meet statistical significance. These findings suggest that postoperative gut microbiota (e.g., Parabacteroides distasonis) may serve as biomarkers in the pathogenesis of postoperative delirium, pending confirmative studies.

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Section: Discussionmentioning

confidence: 89%

The association between gut microbiota and postoperative delirium in patients

Xie¹,

Zhang

Baldyga³

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…Interestingly, the present study did not find associations between the three gut bacteria and the severity of postoperative delirium in patients, as represented by average MDAS scores (Table 2 ) or peak MDAS scores (data not shown). However, a previous study also indicates that some biomarkers are only associated with the incidence, not severity, of postoperative delirium in patients [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

The association between gut microbiota and postoperative delirium in patients

et al. 2023

Self Cite

View full text Add to dashboard Cite

Postoperative delirium is a common postoperative complication in older patients, and its pathogenesis and biomarkers remain largely undetermined. The gut microbiota has been shown to regulate brain function, and therefore, it is vital to explore the association between gut microbiota and postoperative delirium. Of 220 patients (65 years old or older) who had a knee replacement, hip replacement, or laminectomy under general or spinal anesthesia, 86 participants were included in the data analysis. The incidence (primary outcome) and severity of postoperative delirium were assessed for two days. Fecal swabs were collected from participants immediately after surgery. The 16S rRNA gene sequencing was used to assess gut microbiota. Principal component analyses along with a literature review were used to identify plausible gut microbiota, and three gut bacteria were further studied for their associations with postoperative delirium. Of the 86 participants [age 71.0 (69.0–76.0, 25–75% percentile of quartile), 53% female], 10 (12%) developed postoperative delirium. Postoperative gut bacteria Parabacteroides distasonis was associated with postoperative delirium after adjusting for age and sex (Odds Ratio [OR] 2.13, 95% Confidence Interval (CI): 1.09–4.17, P = 0.026). The association between delirium and both Prevotella (OR: 0.59, 95% CI: 0.33–1.04, P = 0.067) and Collinsella (OR: 0.57, 95% CI: 0.27–1.24, P = 0.158) did not meet statistical significance. These findings suggest that there may be an association between postoperative gut microbiota, specifically Parabacteroides distasonis, and postoperative delirium. However, further research is needed to confirm these findings and better understand the gut-brain axis’s role in postoperative outcomes.

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