Perioperative medicine & outcomes
Toward precision risk stratification of postoperative cognitive dysfunction: Preoperative inflammatory and neurodegenerative protein biomarkers in orthopedic surgery: A systematic review
Authors' conclusion
Preoperative CSF amyloid-related biomarkers demonstrated relatively stronger associations with POCD in the available studies; however, evidence remains limited and further validation is required, while multi-marker inflammatory signatures may enhance risk assessment.
Study context
- Population
- Patients undergoing major orthopedic surgery
- Participants
- 705 patients · 6 prospective cohort studies
- Outcome
- POCD in relation to preoperative inflammatory and neurodegenerative protein biomarkers (blood or CSF)
Methodological detailsnarrative synthesis, Risk of bias assessed with the Newcastle-Ottawa Scale
- Narrative synthesis
- Risk of bias assessed with the Newcastle-Ottawa Scale
Pooled result
As reported in the abstract
- Lower preoperative cerebrospinal fluid (CSF) Aβ₁₋₄₂ and reduced Aβ/tau ratios were the most consistent predictors of Postoperative Cognitive Dysfunction (POCD)
- Single serum biomarkers (S100B, inflammatory cytokines) showed variable or limited predictive value
- Composite inflammatory profiles showed potential for identifying patients at risk of long-term cognitive decline
Original publication
Toward precision risk stratification of postoperative cognitive dysfunction: Preoperative inflammatory and neurodegenerative protein biomarkers in orthopedic surgery: A systematic review. J Clin Anesth. Published 16 April 2026. doi:10.
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