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Bacterial extracellular vesicle as a predictive biomarker for postoperative delirium status after spinal surgery: a prospective cohort study

  • 0Department of Pediatrics, Yonsei University College of Medicine, Severance Fecal Microbiota Transplantation Center, Severance Hospital, Seoul, Republic of Korea.
International Journal of Surgery (london, England) +

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August 27, 2025

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August 27, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

The profile of circulating bacteria extracellular vesicles (BEVs) can predict postoperative delirium (POD) in elderly surgical patients. Specific BEV profiles and their metabolite cargo offer new strategies for POD prevention.

Area Of Science

  • Microbiology
  • Geriatric Medicine
  • Surgical Oncology

Background

  • Postoperative delirium (POD) prediction is challenging due to heterogeneous patient cohorts.
  • Bacteria extracellular vesicles (BEVs) are emerging biomarkers for disease prediction.
  • This study investigates BEVs as prognostic factors for POD in a unique surgical patient cohort.

Purpose Of The Study

  • To identify preoperative prognostic factors for postoperative delirium (POD) in spinal surgery patients.
  • To evaluate the predictive performance of bacteria extracellular vesicles (BEVs) for POD.
  • To infer potential metabolites involved in POD pathogenesis and neuroprotection.

Main Methods

  • A prospective cohort study of 128 spinal surgery patients.
  • Random forest classification models were used to predict POD based on baseline characteristics, microbiome data, and BEV profiles.
  • In silico analysis was performed to infer metabolites regulating POD.

Main Results

  • Circulating BEV profiles differed significantly between patients with and without POD.
  • BEV-based prediction models achieved 80% accuracy, outperforming models based on baseline characteristics or gut microbiome.
  • Specific bacterial species (Moraxellaceae, Acinetobacter) and inferred metabolites (succinate, S-methyl-5'-thioadenosine) were identified as key prognostic markers.

Conclusions

  • Preoperative circulating BEV profiles are crucial prognostic indicators for POD in elderly surgical patients.
  • Inferred metabolites from BEVs highlight potential therapeutic targets for POD prevention strategies.

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