CSF Beta-amyloid 1-42 Concentration Predicts Delirium Following Elective Arthroplasty Surgery in an Observational Cohort Study

Emma L Cunningham; Bernadette McGuinness; Daniel F McAuley; Jamie Toombs; Tim Mawhinney; Seamus O'Brien; David Beverland; Jonathan M Schott; Michael P Lunn; Henrik Zetterberg; Anthony P Passmore

doi:10.1097/SLA.0000000000002684

CSF Beta-amyloid 1-42 Concentration Predicts Delirium Following Elective Arthroplasty Surgery in an Observational Cohort Study

Emma L Cunningham, Bernadette McGuinness, Daniel F McAuley, Jamie Toombs, Tim Mawhinney, Seamus O'Brien, David Beverland, Jonathan M Schott, Michael P Lunn, Henrik Zetterberg, Anthony P Passmore

School of Medicine, Dentistry and Biomedical Sciences

Research output: Contribution to journal › Article › peer-review

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Abstract

OBJECTIVE: To test the hypothesis that APOE ε4 status and cerebrospinal fluid (CSF) Aβ42, T-tau and P-tau would independently predict the risk of postoperative delirium.

BACKGROUND: Delirium following surgery is common and associated with adverse outcomes. Age and cognitive impairment are consistent risk factors for postoperative delirium.

METHODS: This observational cohort study recruited 282 participants aged 65 years or older, without a diagnosis of dementia, admitted for primary elective hip or knee arthroplasty. Cognitive tests were undertaken preoperatively, blood and CSF were sampled at the time of spinal anesthesia, and participants were assessed daily postoperatively for delirium.

RESULTS: Increasing age (P = 0.04), preoperative comorbidity (P = 0.03), type of surgery (P = 0.05), intravenous opioid usage (P = 0.04), and low CSF Aβ42 (P < 0.01) were independent predictors of postoperative delirium.

CONCLUSIONS: This study is the first to show an independent association between CSF Aβ42 and delirium incidence in an elective surgical population, suggesting that postoperative delirium may indicate incipient Alzheimer disease.

Original language	English
Journal	Annals of Surgery
Early online date	02 Feb 2018
DOIs	https://doi.org/10.1097/SLA.0000000000002684
Publication status	Early online date - 02 Feb 2018

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Journal Article

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10.1097/SLA.0000000000002684Licence: Unspecified

CSF Beta-amyloid 1-42 Concentration Predicts Delirium Following Elective Arthroplasty Surgery in an Observational Cohort StudyAccepted author manuscript, 154 KB

Emma Cunningham
- emma.cunninghamqub.acuk
- School of Medicine, Dentistry and Biomedical Sciences - Clinical Lecturer
- Centre for Public Health
Person: Academic
Bernadette McGuinness
- B.McGuinnessqub.acuk
- School of Medicine, Dentistry and Biomedical Sciences - Clinical Professor
- Centre for Public Health
Person: Academic
Peter Passmore
- P.Passmorequb.acuk
- School of Medicine, Dentistry and Biomedical Sciences - Professor
- Centre for Public Health
Person: Academic

Cite this

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title = "CSF Beta-amyloid 1-42 Concentration Predicts Delirium Following Elective Arthroplasty Surgery in an Observational Cohort Study",

abstract = "OBJECTIVE: To test the hypothesis that APOE ε4 status and cerebrospinal fluid (CSF) Aβ42, T-tau and P-tau would independently predict the risk of postoperative delirium.BACKGROUND: Delirium following surgery is common and associated with adverse outcomes. Age and cognitive impairment are consistent risk factors for postoperative delirium.METHODS: This observational cohort study recruited 282 participants aged 65 years or older, without a diagnosis of dementia, admitted for primary elective hip or knee arthroplasty. Cognitive tests were undertaken preoperatively, blood and CSF were sampled at the time of spinal anesthesia, and participants were assessed daily postoperatively for delirium.RESULTS: Increasing age (P = 0.04), preoperative comorbidity (P = 0.03), type of surgery (P = 0.05), intravenous opioid usage (P = 0.04), and low CSF Aβ42 (P < 0.01) were independent predictors of postoperative delirium.CONCLUSIONS: This study is the first to show an independent association between CSF Aβ42 and delirium incidence in an elective surgical population, suggesting that postoperative delirium may indicate incipient Alzheimer disease.",

keywords = "Journal Article",

author = "Cunningham, {Emma L} and Bernadette McGuinness and McAuley, {Daniel F} and Jamie Toombs and Tim Mawhinney and Seamus O'Brien and David Beverland and Schott, {Jonathan M} and Lunn, {Michael P} and Henrik Zetterberg and Passmore, {Anthony P}",

year = "2018",

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day = "2",

doi = "10.1097/SLA.0000000000002684",

language = "English",

journal = "Annals of Surgery",

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TY - JOUR

T1 - CSF Beta-amyloid 1-42 Concentration Predicts Delirium Following Elective Arthroplasty Surgery in an Observational Cohort Study

AU - Cunningham, Emma L

AU - McGuinness, Bernadette

AU - McAuley, Daniel F

AU - Toombs, Jamie

AU - Mawhinney, Tim

AU - O'Brien, Seamus

AU - Beverland, David

AU - Schott, Jonathan M

AU - Lunn, Michael P

AU - Zetterberg, Henrik

AU - Passmore, Anthony P

PY - 2018/2/2

Y1 - 2018/2/2

N2 - OBJECTIVE: To test the hypothesis that APOE ε4 status and cerebrospinal fluid (CSF) Aβ42, T-tau and P-tau would independently predict the risk of postoperative delirium.BACKGROUND: Delirium following surgery is common and associated with adverse outcomes. Age and cognitive impairment are consistent risk factors for postoperative delirium.METHODS: This observational cohort study recruited 282 participants aged 65 years or older, without a diagnosis of dementia, admitted for primary elective hip or knee arthroplasty. Cognitive tests were undertaken preoperatively, blood and CSF were sampled at the time of spinal anesthesia, and participants were assessed daily postoperatively for delirium.RESULTS: Increasing age (P = 0.04), preoperative comorbidity (P = 0.03), type of surgery (P = 0.05), intravenous opioid usage (P = 0.04), and low CSF Aβ42 (P < 0.01) were independent predictors of postoperative delirium.CONCLUSIONS: This study is the first to show an independent association between CSF Aβ42 and delirium incidence in an elective surgical population, suggesting that postoperative delirium may indicate incipient Alzheimer disease.

AB - OBJECTIVE: To test the hypothesis that APOE ε4 status and cerebrospinal fluid (CSF) Aβ42, T-tau and P-tau would independently predict the risk of postoperative delirium.BACKGROUND: Delirium following surgery is common and associated with adverse outcomes. Age and cognitive impairment are consistent risk factors for postoperative delirium.METHODS: This observational cohort study recruited 282 participants aged 65 years or older, without a diagnosis of dementia, admitted for primary elective hip or knee arthroplasty. Cognitive tests were undertaken preoperatively, blood and CSF were sampled at the time of spinal anesthesia, and participants were assessed daily postoperatively for delirium.RESULTS: Increasing age (P = 0.04), preoperative comorbidity (P = 0.03), type of surgery (P = 0.05), intravenous opioid usage (P = 0.04), and low CSF Aβ42 (P < 0.01) were independent predictors of postoperative delirium.CONCLUSIONS: This study is the first to show an independent association between CSF Aβ42 and delirium incidence in an elective surgical population, suggesting that postoperative delirium may indicate incipient Alzheimer disease.

KW - Journal Article

U2 - 10.1097/SLA.0000000000002684

DO - 10.1097/SLA.0000000000002684

M3 - Article

C2 - 29401106

JO - Annals of Surgery

JF - Annals of Surgery

SN - 0003-4932

ER -

CSF Beta-amyloid 1-42 Concentration Predicts Delirium Following Elective Arthroplasty Surgery in an Observational Cohort Study

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Emma Cunningham

Bernadette McGuinness

Peter Passmore

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