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Elevated serum alkaline phosphatase correlates with postoperative cognitive dysfunction: A retrospective cohort study

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  • 1Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China.

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|November 7, 2022
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Summary

Elevated serum alkaline phosphatase (ALP) is linked to a higher risk of postoperative cognitive dysfunction (POCD) after general anesthesia. This finding suggests ALP may be a predictive factor for POCD.

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Area of Science:

  • Anesthesiology
  • Biochemistry
  • Neuroscience

Background:

  • Postoperative cognitive dysfunction (POCD) is a significant concern following general anesthesia.
  • The relationship between serum alkaline phosphatase (ALP) and POCD remains largely unexplored.

Purpose of the Study:

  • To investigate the association between serum ALP levels and the incidence of POCD in patients undergoing general anesthesia.
  • To determine if elevated ALP is an independent predictor of POCD.

Main Methods:

  • Retrospective cohort study design.
  • Serum ALP levels measured using a p-nitrophenyl phosphate assay.
  • Cognitive function assessed with the Chinese version of the Mini-Mental State Examination pre- and post-surgery.
  • Univariate, multivariate, and spline regression analyses employed.

Main Results:

  • The incidence of POCD was 13.5%.
  • Patients with POCD exhibited higher serum ALP levels compared to the control group.
  • Elevated ALP levels were significantly associated with increased POCD risk (OR=1.16, P=.000) even after adjusting for confounders.
  • A dose-response relationship was observed between ALP levels and POCD risk.

Conclusions:

  • Elevated serum ALP is an independent predictive factor for POCD at 3-month follow-up.
  • The occurrence of POCD may be associated with the inflammatory status indicated by ALP levels.