The journals of gerontology. Series A, Biological sciences and medical sciences · 2025
Preoperative Plasma p-tau231, p-tau181, and p-tau217 Are Associated With Postoperative Delirium: A Prospective Study.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Wu LiXue, Su JiaBao, Li GuangLing, Zhuang Meng, Sun HaiJian, Zhang JiRu
Аннотация
BACKGROUND: The pathophysiology of delirium remains incompletely understood. The relationship between preoperative plasma concentrations of p-tau181, p-tau231, p-tau217, and T-tau proteins and postoperative delirium (POD) needs further validation. We aimed to verify whether these markers can identify and predict the occurrence and severity of POD.
METHODS: 172 Older adults undergoing laparoscopic surgery were selected from a tertiary comprehensive hospital. All patients received intravenous anesthesia. Preoperative plasma concentrations of p-tau181, p-tau231, p-tau217, and T-tau proteins were measured using enzyme-linked immunosorbent assay. The occurrence and severity of POD were respectively assessed using the 3D-CAM and DRS-R-98 scales.
RESULTS: Of 172 patients (mean age: 72 ± 6 years, 34.9% female), 20 (12%) experienced POD. Patients who developed POD had higher preoperative plasma concentrations of p-tau181, p-tau231, p-tau217, and T-tau than those without. After adjusting for age, ASA, and education, preoperative concentrations of p-tau181 (OR 1.05, 95% CI: 1.03-1.08), p-tau217 (OR 1.02, 95% CI: 1.01-1.04), p-tau231 (OR 1.09, 95% CI: 1.04-1.14), and T-tau (OR 1.01, 95% CI: 1.00-1.02) were independently associated with POD (p<.001). Preoperative plasma p-tau231 showed the highest diagnostic performance with an area under the curve of 0.966, surpassing p-tau181 (0.869), p-tau217 (0.775), and T-tau (0.750). P-tau231 also demonstrated the highest sensitivity (0.900) and specificity (0.967) for predicting POD, compared to p-tau181, p-tau217, and T-tau.
CONCLUSIONS: Preoperative plasma concentrations of p-tau181, p-tau231, and p-tau217 can effectively predict the occurrence and severity of POD in older adult undergoing laparoscopic surgery, with p-tau231 demonstrating higher predictive value.
METHODS: 172 Older adults undergoing laparoscopic surgery were selected from a tertiary comprehensive hospital. All patients received intravenous anesthesia. Preoperative plasma concentrations of p-tau181, p-tau231, p-tau217, and T-tau proteins were measured using enzyme-linked immunosorbent assay. The occurrence and severity of POD were respectively assessed using the 3D-CAM and DRS-R-98 scales.
RESULTS: Of 172 patients (mean age: 72 ± 6 years, 34.9% female), 20 (12%) experienced POD. Patients who developed POD had higher preoperative plasma concentrations of p-tau181, p-tau231, p-tau217, and T-tau than those without. After adjusting for age, ASA, and education, preoperative concentrations of p-tau181 (OR 1.05, 95% CI: 1.03-1.08), p-tau217 (OR 1.02, 95% CI: 1.01-1.04), p-tau231 (OR 1.09, 95% CI: 1.04-1.14), and T-tau (OR 1.01, 95% CI: 1.00-1.02) were independently associated with POD (p<.001). Preoperative plasma p-tau231 showed the highest diagnostic performance with an area under the curve of 0.966, surpassing p-tau181 (0.869), p-tau217 (0.775), and T-tau (0.750). P-tau231 also demonstrated the highest sensitivity (0.900) and specificity (0.967) for predicting POD, compared to p-tau181, p-tau217, and T-tau.
CONCLUSIONS: Preoperative plasma concentrations of p-tau181, p-tau231, and p-tau217 can effectively predict the occurrence and severity of POD in older adult undergoing laparoscopic surgery, with p-tau231 demonstrating higher predictive value.