Cardiothoracic & vascular anesthesia
Serum Neurofilament Light and Postoperative Delirium in Cardiac Surgery: A Preplanned Secondary Analysis of a Prospective Observational Study
Authors' conclusion
Cardiac surgery is associated with axonal injury, because neurofilament light concentrations increased postoperatively in all patients. However, only baseline neurofilament light values predicted postoperative delirium. Baseline concentrations were correlated with poorer cognitive scores, and they independently predicted postoperative delirium whenever patient's cognitive status was undetermined.
Study context
- Population
- Patients undergoing elective cardiac surgery with CPB
- Participants
- 220 patients
- Comparison
- Delirium vs no delirium
- Deliriumn = 65
Methodological detailspreplanned
- Preplanned
Primary result
As reported in the abstract
Postoperative delirium incidence
65 of 220
29.5%
Baseline neurofilament light correlated with cognitive z scores (r)
0.49
P < 0.001
Baseline neurofilament light independently associated with delirium when cognitive status not considered
HR 3.34 [1.07 to 10.4] (95% CI)
Further findings
Age
- Delirious patients older: median [25th, 75th percentile] 74 [64, 79] vs 67 [59, 74] yr
- P < 0.001
Preoperative cognitive z score
- Delirious patients had lower cognitive z scores: −0.52 ± 1.14 vs 0.21 ± 0.84
- P < 0.001
Postoperative serum neurofilament light · up to day 5
- Increased in all patients up to day 5 but did not predict delirium when preoperative concentrations were considered
Original publication
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