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Association Between Plasma Amyloid-Beta 42 Ratio and Postoperative Delirium in Elderly Patients Undergoing Major Abdominal Surgery: Secondary Analysis of a Randomized Controlled Trial

  • 0Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
Brain and Behavior +

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April 22, 2025

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April 22, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

A higher plasma amyloid-beta 42 (Aβ42) ratio is linked to increased postoperative delirium risk and severity in elderly patients undergoing major surgery. This finding suggests plasma Aβ42 may serve as a valuable biomarker for predicting delirium.

Area Of Science

  • Neuroscience
  • Geriatric Medicine
  • Surgical Research

Background

  • Cerebrospinal fluid Aβ42 is linked to cerebral β-amyloidosis and delirium pathophysiology.
  • The association between perioperative plasma Aβ42 levels and postoperative delirium risk in elderly patients is currently unknown.

Purpose Of The Study

  • To investigate the association between perioperative plasma Aβ42 ratio and the risk and severity of postoperative delirium in elderly patients undergoing major abdominal surgery.

Main Methods

  • Secondary analysis of a randomized controlled trial involving 195 patients.
  • Exposure: Plasma Aβ42 ratio (postoperative/preoperative).
  • Primary endpoint: Delirium incidence within 7 days, assessed via Confusion Assessment Method.
  • Secondary endpoint: Delirium severity using Memorial Delirium Assessment Scale.
  • Statistical analysis: Logistic regression, restricted cubic splines, ROC analysis, and mediation analysis.

Main Results

  • A higher plasma Aβ42 ratio was significantly associated with increased delirium risk (aOR 3.21) and severity (aβ 3.04).
  • The relationship between the plasma Aβ42 ratio and delirium incidence was linear.
  • The Aβ42 ratio demonstrated moderate predictive power for delirium risk (AUC 0.698).
  • Matrix metalloproteinase-9 ratio did not mediate the association.

Conclusions

  • Elevated perioperative plasma Aβ42 ratio is a significant predictor of increased postoperative delirium risk and severity.
  • The plasma Aβ42 ratio shows potential as a minimally invasive biomarker for identifying patients at risk of delirium.
  • The association between plasma Aβ42 ratio and delirium is linear.

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