scholarly journals CSF PGRN May be Associated With Postoperative Delirium After Knee Replacement in Elderly Patients: A Prospective Nested Case-Control Study in the PNDABLE Study

2021 ◽  
Author(s):  
Bin Wang ◽  
Xu Lin ◽  
XiuJie Sun ◽  
Fang hao Liu ◽  
He Tao ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Roc Curve ◽  
Postoperative Delirium ◽  
Case Control ◽  
World Health ◽  
Chinese Patients ◽  
World Health Organization Quality ◽  
Duration Of Surgery ◽  
Nested Case Control ◽  
T Tau

Abstract Background: Postoperative delirium (POD) represents a serious complication following anesthesia and surgical procedures for patients undergoing surgical intervention. At present, there is no effective index to predict the occurrence of POD ,so the aim of this study was to validate whether cerebrospinal fluid (CSF) PGRN could predict the occurrence of POD.Methods: We conducted a prospective nested case-control and 1:1 matched (on age, diagnosis, American Society of Anesthesiologist’ (ASA) physical status, duration of surgery, and intraoperative blood loss) study. A total of 600 Han Chinese patients over the age of 65~ 90 who underwent unilateral total knee arthroplasty were included in the PNDABLE study from June 2020 to November 2020. POD cases and non-POD controls were selected from using Confusion Assessment Method (CAM) on the first, second, third and seventh (or before discharge) postoperative days. Delirium severity was measured by the Memorial Delirium Assessment Scale (MDAS). In the six month, cognitive function was assessed with the modified Telephone Interview for Cognitive Status (TICS-m) and the World Health Organization Quality of Life brief version (WHOQOLBREF). CSF PGRN and core biomarkers were measured by ELISA using the microplate reader. The associations of CSF PGRN levels with POD risk and CSF core biomarkers (Aβ1–42, Aβ1–40 ,T-tau and P-tau)were assessed. The effect of CSF PGRN on predicting POD occurrence was evaluated with the area under the receiver operating characteristic (ROC) curve (AUC).Results: POD incidence was 9.7% (53/545). There were significant differences in preoperative CSF PGRN concentration between POD patients and non-POD (P<0.001), and CSF PGRN levels decreased with age, as demonstrated by a significantly negative correlation. CSF PGRN levels decrease with CAM scores and MDAS scores, as demonstrated by significantly negative correlations(r=-0.692, P=0.001; r=-0.435, P=0.001). There were positive associations of CSF PGRN with Aβ1–42 (β = 0.756, P < 0.001) , Aβ1–40 (β =0.637, P < 0.001) and negative associations of CSF PGRN with T-tau (β = -0.716, P < 0.001) and P-tau (β = -0.739, P < 0.001) in POD patients. The ROC curve analysis of PGRN showed that PGRN concentrations had high diagnostic value for POD.Conclusions: Aβ pathology is associated with increasing in CSF PGRN whereas Tau pathology and neurodegeneration is associated with decreasing in CSF PGRN in POD patients.CSF PGRN can predict the occurrence of POD in elderly patients．Clinical Trial Registration: www.clinicaltrials.gov, identifier ChiCTR2000033439.

CSF PGRN May be Associated With Postoperative Delirium After Knee Replacement in Elderly Patients: The PNDABLE Study

2021 ◽  
Author(s):  
Bin Wang ◽  
Jie Xiu Sun ◽  
He Tao ◽  
Yuan Xi Deng ◽  
Nan Ya Lin ◽  
...  
Keyword(s):  
Postoperative Delirium ◽  
Cognitive Disorders ◽  
Diagnostic Value ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Chinese Patients ◽  
Roc Curve Analysis ◽  
Duration Of Surgery ◽  
Total Knee ◽  
T Tau

Abstract BackgroundPostoperative delirium (POD) represents a serious complication following anesthesia and surgical procedures for patients undergoing surgical intervention (1). Little is known about the mechanisms underlying similarities in the core features between postoperative delirium (POD) and progranulin (PGRN)-related cognitive disorders. We herein investigated the relationship between preoperative CSF PGRN concentration and POD occurrence in the Han Chinese patients undergoing unilateral total knee arthroplasty.MethodsWe conducted an observational, prospective, and 1:1 matched (on age older than 65, the unilateral total knee arthroplasty, American Society of Anesthesiologist’ (ASA) physical status, duration of surgery, and intraoperative bleeding) case-control study. POD cases and non-POD controls were selected from the overall cohort using Confusion Assessment Method (CAM). Delirium severity was measured by the Memorial Delirium Assessment Scale (MDAS). CSF PGRN and core biomarkers were measured by ELISA using the microplate reader. The associations of CSF PGRN levels with POD risk and CSF core biomarkers were assessed.ResultsPOD incidence was 9.7% (53/545). There were significant differences in preoperative CSF PGRN concentration between POD patients and controls (P<0.001), and CSF PGRN levels increased with age, as demonstrated by a significantly positive correlation (r=0.796, P<0.001).CSF PGRN levels to increase with CAM scores and MDAS scores, as demonstrated by significantly positive correlations (r=0.693, P<0.001; r=0.590, P<0.001). There were positive associations of CSF PGRN with T-tau (β = -0.501, P < 0.001) and P-tau (β = -0.470, P < 0.001) and negative associations of CSF PGRN with Aβ1–42 (β = -0.576, P < 0.001), Aβ1–40 (β = -0.488, P < 0.001), Aβ42/p-tau (β = -0.422, P < 0.001), and Aβ42 / T- tau (β = -0.395, P < 0.001) in POD patients. The ROC curve analysis of PGRN showed that PGRN concentrations had high diagnostic value for POD.ConclusionsCSF PGRN may be associated with the POD. Aβ pathology is associated with a decrease in CSF PGRN in the absence of tau deposition and neurodegeneration, whereas tau pathology and neurodegeneration is associated with an increase in CSF PGRN.Clinical Trial Registrationwww.clinicaltrials.gov, identifier ChiCTR2000033439.

scholarly journals Perioperative urinary thromboxane metabolites and outcome of coronary artery bypass grafting: a nested case-control study

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e021219
Author(s):  
Hanning Liu ◽  
Zhengxi Xu ◽  
Cheng Sun ◽  
Qianlong Chen ◽  
Ning Bao ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Case Control Study ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Case Control ◽  
Chinese Patients ◽  
Cabg Surgery ◽  
Nested Case Control ◽  
Control Study

ObjectiveAs a marker of in vivo thromboxane generation, high-level urinary thromboxane metabolites (TXA-M) increase the occurrence of cardiovascular events in high-risk patients. To investigate whether perioperative urinary TXA-M level is associated with major adverse cardiac and cerebrovascular events (MACCE) after coronary artery bypass graft (CABG) surgery, we designed a nested case-control study.DesignObservational, nested case-control study.SettingSingle-centre outcomes research in Fuwai Hospital, Beijing, China.ParticipantsOne thousand six hundred and seventy Chinese patients undergoing CABG surgery from September 2011 to October 2013.MethodsWe obtained urinary samples from 1670 Chinese patients undergoing CABG 1 hour before surgery (pre-CABG), and 6 hours (post-CABG 6 hours) and 24 hours after surgery (post-CABG 24 hours). Patients were followed up for 1 year, and we observed 56 patients had MACCE. For each patient with MACCE, we matched three control subjects. Perioperative urinary TXA-M of the three time spots was detected in these 224 patients.ResultsPost-CABG 24 hours TXA-M is significantly higher than that of patients without MACCE (11 101vs8849 pg/mg creatine, P=0.007). In addition, patients in the intermediate tertile and upper tertile of post-CABG 24 hours urinary TXA-M have a 2.2 times higher (HR 2.22, 95% CI 1.04 to 4.71, P=0.038) and a 2.8 times higher (HR 2.81, 95% CI 1.35 to 5.85, P=0.006) risk of 1 year MACCE than those in the lower tertile, respectively.ConclusionsIn conclusion, post-CABG 24 hours urinary TXA-M elevation is associated with an increase of 1 year adverse events after CABG, indicating that the induction of cyclo-oxygenase-2 by surgery-related inflammatory stimuli or platelet turnover may be responsible for the high levels of post-CABG urinary TXA-M.Trial registration numberNCT01573143.

scholarly journals Cut-off point for WHOQOL-bref as a measure of quality of life of older adults

2014 ◽  
Vol 48 (3) ◽  
pp. 390-397 ◽  
Author(s):  
Patrícia Aparecida Barbosa Silva ◽  
Sônia Maria Soares ◽  
Joseph Fabiano Guimarães Santos ◽  
Líliam Barbosa Silva
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Roc Curve ◽  
Characteristic Curve ◽  
Perceived Quality ◽  
World Health ◽  
Southeastern Brazil ◽  
World Health Organization Quality ◽  
Perceived Quality Of Life

OBJECTIVE To propose a cut-off for the World Health Organization Quality of Life-Bref (WHOQOL-bref) as a predictor of quality of life in older adults. METHODS Cross-sectional study with 391 older adults registered in the Northwest Health District in Belo Horizonte, MG, Southeastern Brazil, between October 8, 2010 and May 23, 2011. The older adults’ quality of life was measured using the WHOQOL-bref. The analysis was rationalized by outlining two extreme and simultaneous groups according to perceived quality of life and satisfaction with health (quality of life good/satisfactory – good or very good self-reported quality of life and being satisfied or very satisfied with health – G5; and poor/very poor quality of life – poor or very poor self-reported quality of life and feeling dissatisfied or very dissatisfied with health – G6). A Receiver-Operating Characteristic curve (ROC) was created to assess the diagnostic ability of different cut-off points of the WHOQOL-bref. RESULTS ROC curve analysis indicated a critical value 60 as the optimal cut-off point for assessing perceived quality of life and satisfaction with health. The area under the curve was 0.758, with a sensitivity of 76.8% and specificity of 63.8% for a cut-off of ≥ 60 for overall quality of life (G5) and sensitivity 95.0% and specificity of 54.4% for a cut-off of < 60 for overall quality of life (G6). CONCLUSIONS Diagnostic interpretation of the ROC curve revealed that cut-off < 60 for overall quality of life obtained excellent sensitivity and negative predictive value for tracking older adults with probable worse quality of life and dissatisfied with health.

scholarly journals Trimethoprim-sulfamethoxazole induced hyperkalaemia in elderly patients receiving spironolactone: nested case-control study

BMJ ◽  
2011 ◽  
Vol 343 (sep12 1) ◽  
pp. d5228-d5228 ◽  
Author(s):  
T. Antoniou ◽  
T. Gomes ◽  
M. M. Mamdani ◽  
Z. Yao ◽  
C. Hellings ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Case Control Study ◽  
Case Control ◽  
Nested Case Control ◽  
Control Study

scholarly journals Correlation of the aesthetic component of dental health and emotional state in patients with different anxiety levels

2018 ◽  
Vol 10 (3) ◽  
pp. 54-58
Author(s):  
O. I. Lobach ◽  
V. N. Nikolenko ◽  
E. K. Rustamova ◽  
N. V. Lapina ◽  
E. V. Kochurova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
State Anxiety ◽  
Dental Health ◽  
World Health ◽  
World Health Organization Quality ◽  
Aesthetic Appearance ◽  
Anxiety Levels ◽  
The Aesthetic

Objective: to investigate the influence of the aesthetic component of dental health on the anxiety level and quality of life of socially active elderly patients. Patients and methods. A total of 32 patients aged 60 to 67 years who had a poor aesthetic appearance of the hard tissues of the front teeth were followed up. All the patients underwent determination of anxiety levels by the Spielberger–Hanin procedure and assessment of quality of life using an abbreviated 26-item version of the World Health Organization Quality of Life (WHOQOL-BREF-26) questionnaire; the updated Oral Health Impact Profile (OHIP-14) was also used. Aesthetic rehabilitation of vital front teeth was carried out using photo composite materials made in Russian and foreign countries. Results. Before treatment, the state anxiety scores were 54±1.4 scores; the trait anxiety ones were 41±1.2 scores; at 1 week after treatment, these were 42±0.5 and 39±0.6, respectively (p ≤ 0.05 for both indicators), and at 6 months, these were 44±0.5 and 43±0.7, respectively. Conclusion. The aesthetic component of dental health in socially active elderly patients is directly proportional to quality of life and inversely proportional to the level of trait or state anxiety. Russian and foreign photo composite restorative materials showed equal sustained performance.

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