Association between plasma tau and postoperative delirium incidence and severity: a prospective observational study
Postoperative delirium is associated with increases in the neuronal injury biomarker, neurofilament light (NfL). Here we tested whether two other biomarkers, glial fibrillary acidic protein (GFAP) and tau, are associated with postoperative delirium. A total of 114 surgical patients were recruited in...
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| Veröffentlicht in: | British journal of anaesthesia : BJA 2021-02, Vol.126 (2), p.458-466 |
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| creator | Ballweg, Tyler White, Marissa Parker, Margaret Casey, Cameron Bo, Amber Farahbakhsh, Zahra Kayser, Austin Blair, Alexander Lindroth, Heidi Pearce, Robert A. Blennow, Kaj Zetterberg, Henrik Lennertz, Richard Sanders, Robert D. |
| description | Postoperative delirium is associated with increases in the neuronal injury biomarker, neurofilament light (NfL). Here we tested whether two other biomarkers, glial fibrillary acidic protein (GFAP) and tau, are associated with postoperative delirium.
A total of 114 surgical patients were recruited into two prospective biomarker cohort studies with assessment of delirium severity and incidence. Plasma samples were sent for biomarker analysis including tau, NfL, and GFAP, and a panel of 10 cytokines. We determined a priori to adjust for interleukin-8 (IL-8), a marker of inflammation, when assessing associations between biomarkers and delirium incidence and severity.
GFAP concentrations showed no relationship to delirium. The change in tau from preoperative concentrations to postoperative Day 1 was greater in patients with postoperative delirium (P |
| doi_str_mv | 10.1016/j.bja.2020.08.061 |
| format | Article |
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A total of 114 surgical patients were recruited into two prospective biomarker cohort studies with assessment of delirium severity and incidence. Plasma samples were sent for biomarker analysis including tau, NfL, and GFAP, and a panel of 10 cytokines. We determined a priori to adjust for interleukin-8 (IL-8), a marker of inflammation, when assessing associations between biomarkers and delirium incidence and severity.
GFAP concentrations showed no relationship to delirium. The change in tau from preoperative concentrations to postoperative Day 1 was greater in patients with postoperative delirium (P<0.001) and correlated with delirium severity (ρ=0.39, P<0.001). The change in tau correlated with increases in IL-8 (P<0.001) and IL-10 (P=0.0029). Linear regression showed that the relevant clinical predictors of tau changes were age (P=0.037), prior stroke/transient ischaemic attack (P=0.001), and surgical blood loss (P<0.001). After adjusting for age, sex, preoperative cognition, and change in IL-8, tau remained significantly associated with delirium severity (P=0.026). Using linear mixed effect models, only tau (not NfL or IL-8) predicted recovery from delirium (P<0.001).
The change in plasma tau was associated with delirium incidence and severity, and resolved over time in parallel with delirium features. The impact of this putative perioperative neuronal injury biomarker on long-term cognition merits further investigation.
NCT02926417 and NCT03124303.</description><identifier>ISSN: 0007-0912</identifier><identifier>ISSN: 1471-6771</identifier><identifier>EISSN: 1471-6771</identifier><identifier>DOI: 10.1016/j.bja.2020.08.061</identifier><identifier>PMID: 33228978</identifier><language>eng</language><publisher>OXFORD: Elsevier Ltd</publisher><subject>Aged ; Anesthesiology ; biomarker ; Biomarkers - blood ; delirium ; Delirium - blood ; Delirium - diagnosis ; Delirium - epidemiology ; Female ; glial fibrillary acidic protein ; Glial Fibrillary Acidic Protein - blood ; Humans ; Incidence ; inflammation ; Interleukin-8 - blood ; Life Sciences & Biomedicine ; Male ; neuronal injury ; Neuroscience and Neuroanaesthesia ; Neurosciences ; Neurovetenskaper ; postoperative ; Postoperative Complications - blood ; Postoperative Complications - diagnosis ; Postoperative Complications - epidemiology ; Predictive Value of Tests ; Prospective Studies ; Science & Technology ; Severity of Illness Index ; surgery ; tau ; tau Proteins - blood ; Time Factors</subject><ispartof>British journal of anaesthesia : BJA, 2021-02, Vol.126 (2), p.458-466</ispartof><rights>2020 British Journal of Anaesthesia</rights><rights>Copyright © 2020 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.</rights><rights>2020 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved. 2020 British Journal of Anaesthesia</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>73</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000609397000031</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c555t-3afdccadb84dab6b032fe5de3958cb187c80ee638dc1831b4cf251d7b1d4fc133</citedby><cites>FETCH-LOGICAL-c555t-3afdccadb84dab6b032fe5de3958cb187c80ee638dc1831b4cf251d7b1d4fc133</cites><orcidid>0000-0002-5389-4701 ; 0000-0001-6790-2170 ; 0000-0003-0113-0328</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,782,786,887,27931,27932,39265</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33228978$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://gup.ub.gu.se/publication/298983$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Ballweg, Tyler</creatorcontrib><creatorcontrib>White, Marissa</creatorcontrib><creatorcontrib>Parker, Margaret</creatorcontrib><creatorcontrib>Casey, Cameron</creatorcontrib><creatorcontrib>Bo, Amber</creatorcontrib><creatorcontrib>Farahbakhsh, Zahra</creatorcontrib><creatorcontrib>Kayser, Austin</creatorcontrib><creatorcontrib>Blair, Alexander</creatorcontrib><creatorcontrib>Lindroth, Heidi</creatorcontrib><creatorcontrib>Pearce, Robert A.</creatorcontrib><creatorcontrib>Blennow, Kaj</creatorcontrib><creatorcontrib>Zetterberg, Henrik</creatorcontrib><creatorcontrib>Lennertz, Richard</creatorcontrib><creatorcontrib>Sanders, Robert D.</creatorcontrib><title>Association between plasma tau and postoperative delirium incidence and severity: a prospective observational study</title><title>British journal of anaesthesia : BJA</title><addtitle>BRIT J ANAESTH</addtitle><addtitle>Br J Anaesth</addtitle><description>Postoperative delirium is associated with increases in the neuronal injury biomarker, neurofilament light (NfL). Here we tested whether two other biomarkers, glial fibrillary acidic protein (GFAP) and tau, are associated with postoperative delirium.
A total of 114 surgical patients were recruited into two prospective biomarker cohort studies with assessment of delirium severity and incidence. Plasma samples were sent for biomarker analysis including tau, NfL, and GFAP, and a panel of 10 cytokines. We determined a priori to adjust for interleukin-8 (IL-8), a marker of inflammation, when assessing associations between biomarkers and delirium incidence and severity.
GFAP concentrations showed no relationship to delirium. The change in tau from preoperative concentrations to postoperative Day 1 was greater in patients with postoperative delirium (P<0.001) and correlated with delirium severity (ρ=0.39, P<0.001). The change in tau correlated with increases in IL-8 (P<0.001) and IL-10 (P=0.0029). Linear regression showed that the relevant clinical predictors of tau changes were age (P=0.037), prior stroke/transient ischaemic attack (P=0.001), and surgical blood loss (P<0.001). After adjusting for age, sex, preoperative cognition, and change in IL-8, tau remained significantly associated with delirium severity (P=0.026). Using linear mixed effect models, only tau (not NfL or IL-8) predicted recovery from delirium (P<0.001).
The change in plasma tau was associated with delirium incidence and severity, and resolved over time in parallel with delirium features. The impact of this putative perioperative neuronal injury biomarker on long-term cognition merits further investigation.
NCT02926417 and NCT03124303.</description><subject>Aged</subject><subject>Anesthesiology</subject><subject>biomarker</subject><subject>Biomarkers - blood</subject><subject>delirium</subject><subject>Delirium - blood</subject><subject>Delirium - diagnosis</subject><subject>Delirium - epidemiology</subject><subject>Female</subject><subject>glial fibrillary acidic protein</subject><subject>Glial Fibrillary Acidic Protein - blood</subject><subject>Humans</subject><subject>Incidence</subject><subject>inflammation</subject><subject>Interleukin-8 - blood</subject><subject>Life Sciences & Biomedicine</subject><subject>Male</subject><subject>neuronal injury</subject><subject>Neuroscience and Neuroanaesthesia</subject><subject>Neurosciences</subject><subject>Neurovetenskaper</subject><subject>postoperative</subject><subject>Postoperative Complications - blood</subject><subject>Postoperative Complications - diagnosis</subject><subject>Postoperative Complications - epidemiology</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Science & Technology</subject><subject>Severity of Illness Index</subject><subject>surgery</subject><subject>tau</subject><subject>tau Proteins - blood</subject><subject>Time Factors</subject><issn>0007-0912</issn><issn>1471-6771</issn><issn>1471-6771</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><sourceid>EIF</sourceid><recordid>eNqNkk2r1DAUhoso3vHqD3AjWQrSmjT9SBWEy-AXXHCj65CP0zFD29Qk7TD_3rQdB-9GXCUkz3tOkidJ8pLgjGBSvT1m8iiyHOc4wyzDFXmU7EhRk7Sqa_I42WGM6xQ3JL9Jnnl_xJjUeVM-TW4ozXPW1GyX-DvvrTIiGDsgCeEEMKCxE74XKIgJiUGj0fpgR3ARmgFp6IwzU4_MoIyGQcEKeZjBmXB-hwQanfUjqBW30oOb1_qiQz5M-vw8edKKzsOLy3ib_Pj08fv-S3r_7fPX_d19qsqyDCkVrVZKaMkKLWQlMc1bKDXQpmRKElYrhgEqyrQijBJZqDYvia4l0UWrCKW3SbrV9ScYJ8lHZ3rhztwKww_TyOPSYeIeeN6whi38h42PcA9awRCc6B7EHu4M5ic_2JkzTIpmbfj6UsDZXxP4wHvjFXSdGMBOnudFVUSywiyiZENVfCvvoL22IZgvcvmRR7l8kcsx41FuzLz6-3zXxB-bEXizASeQtvXKLHauWPwNFW5oU8cJpks59v_03oTV4d5OQ4jR91sUor7ZgOOXuDYueufamn_c4zeKxdth</recordid><startdate>20210201</startdate><enddate>20210201</enddate><creator>Ballweg, Tyler</creator><creator>White, Marissa</creator><creator>Parker, Margaret</creator><creator>Casey, Cameron</creator><creator>Bo, Amber</creator><creator>Farahbakhsh, Zahra</creator><creator>Kayser, Austin</creator><creator>Blair, Alexander</creator><creator>Lindroth, Heidi</creator><creator>Pearce, Robert A.</creator><creator>Blennow, Kaj</creator><creator>Zetterberg, Henrik</creator><creator>Lennertz, Richard</creator><creator>Sanders, Robert D.</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>F1U</scope><orcidid>https://orcid.org/0000-0002-5389-4701</orcidid><orcidid>https://orcid.org/0000-0001-6790-2170</orcidid><orcidid>https://orcid.org/0000-0003-0113-0328</orcidid></search><sort><creationdate>20210201</creationdate><title>Association between plasma tau and postoperative delirium incidence and severity: a prospective observational study</title><author>Ballweg, Tyler ; White, Marissa ; Parker, Margaret ; Casey, Cameron ; Bo, Amber ; Farahbakhsh, Zahra ; Kayser, Austin ; Blair, Alexander ; Lindroth, Heidi ; Pearce, Robert A. ; Blennow, Kaj ; Zetterberg, Henrik ; Lennertz, Richard ; Sanders, Robert D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c555t-3afdccadb84dab6b032fe5de3958cb187c80ee638dc1831b4cf251d7b1d4fc133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Anesthesiology</topic><topic>biomarker</topic><topic>Biomarkers - blood</topic><topic>delirium</topic><topic>Delirium - blood</topic><topic>Delirium - diagnosis</topic><topic>Delirium - epidemiology</topic><topic>Female</topic><topic>glial fibrillary acidic protein</topic><topic>Glial Fibrillary Acidic Protein - blood</topic><topic>Humans</topic><topic>Incidence</topic><topic>inflammation</topic><topic>Interleukin-8 - blood</topic><topic>Life Sciences & Biomedicine</topic><topic>Male</topic><topic>neuronal injury</topic><topic>Neuroscience and Neuroanaesthesia</topic><topic>Neurosciences</topic><topic>Neurovetenskaper</topic><topic>postoperative</topic><topic>Postoperative Complications - blood</topic><topic>Postoperative Complications - diagnosis</topic><topic>Postoperative Complications - epidemiology</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Science & Technology</topic><topic>Severity of Illness Index</topic><topic>surgery</topic><topic>tau</topic><topic>tau Proteins - blood</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ballweg, Tyler</creatorcontrib><creatorcontrib>White, Marissa</creatorcontrib><creatorcontrib>Parker, Margaret</creatorcontrib><creatorcontrib>Casey, Cameron</creatorcontrib><creatorcontrib>Bo, Amber</creatorcontrib><creatorcontrib>Farahbakhsh, Zahra</creatorcontrib><creatorcontrib>Kayser, Austin</creatorcontrib><creatorcontrib>Blair, Alexander</creatorcontrib><creatorcontrib>Lindroth, Heidi</creatorcontrib><creatorcontrib>Pearce, Robert A.</creatorcontrib><creatorcontrib>Blennow, Kaj</creatorcontrib><creatorcontrib>Zetterberg, Henrik</creatorcontrib><creatorcontrib>Lennertz, Richard</creatorcontrib><creatorcontrib>Sanders, Robert D.</creatorcontrib><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Göteborgs universitet</collection><jtitle>British journal of anaesthesia : BJA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ballweg, Tyler</au><au>White, Marissa</au><au>Parker, Margaret</au><au>Casey, Cameron</au><au>Bo, Amber</au><au>Farahbakhsh, Zahra</au><au>Kayser, Austin</au><au>Blair, Alexander</au><au>Lindroth, Heidi</au><au>Pearce, Robert A.</au><au>Blennow, Kaj</au><au>Zetterberg, Henrik</au><au>Lennertz, Richard</au><au>Sanders, Robert D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association between plasma tau and postoperative delirium incidence and severity: a prospective observational study</atitle><jtitle>British journal of anaesthesia : BJA</jtitle><stitle>BRIT J ANAESTH</stitle><addtitle>Br J Anaesth</addtitle><date>2021-02-01</date><risdate>2021</risdate><volume>126</volume><issue>2</issue><spage>458</spage><epage>466</epage><pages>458-466</pages><issn>0007-0912</issn><issn>1471-6771</issn><eissn>1471-6771</eissn><abstract>Postoperative delirium is associated with increases in the neuronal injury biomarker, neurofilament light (NfL). Here we tested whether two other biomarkers, glial fibrillary acidic protein (GFAP) and tau, are associated with postoperative delirium.
A total of 114 surgical patients were recruited into two prospective biomarker cohort studies with assessment of delirium severity and incidence. Plasma samples were sent for biomarker analysis including tau, NfL, and GFAP, and a panel of 10 cytokines. We determined a priori to adjust for interleukin-8 (IL-8), a marker of inflammation, when assessing associations between biomarkers and delirium incidence and severity.
GFAP concentrations showed no relationship to delirium. The change in tau from preoperative concentrations to postoperative Day 1 was greater in patients with postoperative delirium (P<0.001) and correlated with delirium severity (ρ=0.39, P<0.001). The change in tau correlated with increases in IL-8 (P<0.001) and IL-10 (P=0.0029). Linear regression showed that the relevant clinical predictors of tau changes were age (P=0.037), prior stroke/transient ischaemic attack (P=0.001), and surgical blood loss (P<0.001). After adjusting for age, sex, preoperative cognition, and change in IL-8, tau remained significantly associated with delirium severity (P=0.026). Using linear mixed effect models, only tau (not NfL or IL-8) predicted recovery from delirium (P<0.001).
The change in plasma tau was associated with delirium incidence and severity, and resolved over time in parallel with delirium features. The impact of this putative perioperative neuronal injury biomarker on long-term cognition merits further investigation.
NCT02926417 and NCT03124303.</abstract><cop>OXFORD</cop><pub>Elsevier Ltd</pub><pmid>33228978</pmid><doi>10.1016/j.bja.2020.08.061</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-5389-4701</orcidid><orcidid>https://orcid.org/0000-0001-6790-2170</orcidid><orcidid>https://orcid.org/0000-0003-0113-0328</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Anesthesiology biomarker Biomarkers - blood delirium Delirium - blood Delirium - diagnosis Delirium - epidemiology Female glial fibrillary acidic protein Glial Fibrillary Acidic Protein - blood Humans Incidence inflammation Interleukin-8 - blood Life Sciences & Biomedicine Male neuronal injury Neuroscience and Neuroanaesthesia Neurosciences Neurovetenskaper postoperative Postoperative Complications - blood Postoperative Complications - diagnosis Postoperative Complications - epidemiology Predictive Value of Tests Prospective Studies Science & Technology Severity of Illness Index surgery tau tau Proteins - blood Time Factors |
| title | Association between plasma tau and postoperative delirium incidence and severity: a prospective observational study |
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