Serum CRP and urinary trypsin inhibitor implicate postoperative cognitive dysfunction especially in elderly patients

Area of Science:

• Neuroscience
• Immunology
• Geriatrics

Background:

• Postoperative cognitive dysfunction (POCD) is a decline in memory and executive function after surgery.
• The precise mechanisms and contributing factors to POCD remain incompletely understood.
• Inflammatory responses and specific biomarkers are suspected to play a role in POCD development.

Purpose of the Study:

• To investigate the association between inflammatory cytokines, urinary trypsin inhibitor (uTi), and the incidence of POCD.
• To identify potential biomarkers for predicting POCD risk after major surgery.

Main Methods:

• A study involving 63 patients undergoing lumbar discectomy and 47 age-matched controls.
• Measurement of serum inflammatory markers (CRP, IL-6, IL-10, MMP-9) and urinary trypsin inhibitor/creatinine (uTi/Ucr) ratios.
• Cognitive function assessed using the Montreal Cognitive Assessment (MoCA) test.

Main Results:

• Patients with POCD exhibited significantly higher levels of IL-6, IL-10, CRP, MMP-9, and uTi/Ucr compared to those without POCD.
• POCD occurred more frequently in the elderly group (43.75%) than in the middle-aged group (19.35%).
• Serum CRP at 72 hours and urinary uTi/Ucr at 24 hours postoperation were identified as independent risk factors for POCD.

Conclusions:

• Increased postoperative inflammation, particularly in the elderly, may contribute to a higher incidence of POCD.
• Elevated serum CRP and urinary uTi/Ucr levels post-surgery are significant predictors of POCD.
• These findings highlight potential biomarkers for early identification and management of POCD risk.