Perioperative medicine & outcomes
Effect of remote ischemic preconditioning on perioperative neurocognitive disorder in elderly patients undergoing major surgery and associated genetic variant analysis: a randomized clinical trial
Authors' conclusion
RIPC had little effect on the incidence of PND in elderly patients who underwent major surgery (> 2 h). MD2 and cystatin C were unable to predict the occurrence of PND. Patients harboring rs4824145 in the Shank3 gene may be more susceptible to PND.
Study context
- Population
- Elderly patients undergoing major surgery (> 2 h) under GA250 screened
- Participants
- 120 patients
- Comparison
- Remote ischemic preconditioning (RIPC) vs control
- Primary endpoint
- Incidence of PND (six neurological tests before and after surgery)
Methodological detailssham-controlled (cuff 60 mmHg)
- Sham-controlled (cuff 60 mmHg)
Primary result
As reported in the abstract
Incidence of PND
P = 0.982
Further findings
Serum MD2 and cystatin C, NPND vs perioperative neurocognitive disorder (PND)
- No significant difference in MD2 or cystatin C concentrations between NPND and PND
Genetic variants in PND patients (whole genome sequencing)
- Mutated genes exclusively identified in PND patients
- 3877
- Mutated genes enriched in synapse function (Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis), including a Shank3 variant (SNP rs4824145)
Original publication
Effect of remote ischemic preconditioning on perioperative neurocognitive disorder in elderly patients undergoing major surgery and associated genetic variant analysis: a randomized clinical trial. Perioper Med (Lond). Published 5 February 2025. doi:10.
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