Surgery May Be a Major Contributor for Postoperative Delirium in Patients With Elective Thoracic Aortic Aneurysm Procedures

IF 5 1区医学 Q1 NEUROSCIENCES

CNS Neuroscience & Therapeutics Pub Date : 2025-07-09 DOI:10.1111/cns.70509

Lucas G. Fernandez, Weiran Shan, Abdullah S. Terkawi, Sandeep Yerra, Zhiyi Zuo

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Abstract

Aims

Postoperative delirium (POD) is relatively common and is associated with poor outcomes. Age is a risk factor for POD. This single-center observational study is designed to determine whether surgery is a major contributor to the development of POD and inflammatory response.

Methods

Patients with elective procedures to repair thoracic aortic aneurysm were recruited to the study. Confusion Assessment Method was used to assess POD. Their blood and cerebrospinal fluids were harvested for analysis of inflammatory and neuronal injury indicators.

Results

A total of 67 patients were included in this study: 32 had stent placement under general anesthesia and 35 had open surgery to repair the aneurysm. No patients in the stent placement group had POD, but 9 patients in the open surgery group had POD (25.7%). Patients with POD had a lower body temperature at the end of surgery than patients without POD [36.3°C (35.7°C–36.6°C) vs. 36.7°C (36.3°C–37.0°C), p = 0.046]. This parameter was identified as a risk factor for POD. Patients in the open surgery group had increased interleukin 1β and neurofilament light chain in the blood. However, there was no change in these biomarkers in the cerebrospinal fluids at 10 and 24 h after surgery.

Conclusion

Our results suggest that surgery is a major contributor to POD, inflammatory response, and neuronal injury. Low body temperature at the end of surgery is a potential risk factor for POD in patients with open repair for thoracic aortic aneurysm.

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手术可能是选择性胸主动脉瘤手术患者术后谵妄的主要原因

目的术后谵妄（POD）较为常见，预后较差。年龄是POD的一个危险因素。这项单中心观察性研究旨在确定手术是否是POD和炎症反应发展的主要因素。方法选取择期行胸主动脉瘤修复术的患者作为研究对象。采用混淆评定法对POD进行评定。收集他们的血液和脑脊液用于分析炎症和神经元损伤指标。结果本研究共纳入67例患者，其中32例在全麻下行支架置入术，35例行开腹手术修复动脉瘤。支架置入组无一例发生POD，开放手术组9例（25.7%）发生POD。POD患者手术结束时体温低于非POD患者[36.3°C(35.7°C - 36.6°C) vs 36.7°C(36.3°C - 37.0°C), p = 0.046]。该参数被确定为POD的危险因素。开放手术组患者血液中白细胞介素1β和神经丝轻链升高。然而，术后10和24小时脑脊液中这些生物标志物没有变化。结论手术是POD、炎症反应和神经元损伤的主要因素。手术结束时低体温是胸主动脉瘤开放性修复患者发生POD的潜在危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CNS Neuroscience & Therapeutics 医学-神经科学

CiteScore

7.30

自引率

12.70%

发文量

240

审稿时长

2 months

期刊介绍： CNS Neuroscience & Therapeutics provides a medium for rapid publication of original clinical, experimental, and translational research papers, timely reviews and reports of novel findings of therapeutic relevance to the central nervous system, as well as papers related to clinical pharmacology, drug development and novel methodologies for drug evaluation. The journal focuses on neurological and psychiatric diseases such as stroke, Parkinson’s disease, Alzheimer’s disease, depression, schizophrenia, epilepsy, and drug abuse.