Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
E-pub ahead of print

Biomarkers of Cerebral Injury for Prediction of Postoperative Cognitive Dysfunction in Patients Undergoing Cardiac Surgery

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Perioperative Anemia Management as Part of PBM in Cardiac Surgery - A Narrative Updated Review

    Research output: Contribution to journalReviewResearchpeer-review

  2. Preliminary Experience Using Diastolic Right Ventricular Pressure Gradient Monitoring in Cardiac Surgery

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Comprehensive Physiological Modeling Provides Novel Insights Into Heart Failure With Preserved Ejection Fraction Physiology

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Ketamine versus propofol for rapid sequence induction in trauma patients: a retrospective study

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Central and peripheral nervous system complications of COVID-19: a prospective tertiary center cohort with 3-month follow-up

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

OBJECTIVES: To assess the ability of the biomarkers neuron-specific enolase (NSE), tau, neurofilament light chain (NFL), and glial fibrillary acidic protein (GFAP) to predict postoperative cognitive dysfunction (POCD) at discharge in patients who underwent cardiac surgery.

DESIGN: Post hoc analyses (with tests being prespecified before data analyses) from a randomized clinical trial.

SETTING: Single-center study from a primary heart center in Denmark.

PARTICIPANTS: Adult patients undergoing elective or subacute on-pump coronary artery bypass grafting and/or aortic valve replacement.

INTERVENTIONS: Blood was collected before induction of anesthesia, after 24 hours, after 48 hours, and at discharge from the surgical ward. The International Study of Postoperative Cognitive Dysfunction test battery was applied to diagnose POCD at discharge and after three months. Linear mixed models of covariance were used to assess whether repeated measurements of biomarker levels were associated with POCD. Receiver operating characteristic (ROC) curves were applied to assess the predictive value of each biomarker measurement for POCD.

MEASUREMENTS AND MAIN RESULTS: A total of 168 patients had biomarkers measured at baseline, and 47 (28%) fulfilled the POCD criteria at discharge. Patients with POCD at discharge had significantly higher levels of tau (p = 0.02) and GFAP (p = 0.01) from baseline to discharge. The biomarker measurements achieving the highest area under the ROC curve for prediction of POCD at discharge were NFL measured at discharge (AUC, 0.64; 95% confidence interval [CI], 0.54-0.73), GFAP measured 48 hours after induction (AUC, 0.64; 95% CI, 0.55-0.73), and GFAP measured at discharge (AUC, 0.64; 95% CI, 0.54-0.74), corresponding to a moderate predictive ability.

CONCLUSIONS: Postoperative serum levels of tau and GFAP were elevated significantly in patients with POCD who underwent cardiac surgery at discharge; however, the biomarkers achieved only modest predictive abilities for POCD at discharge. Postoperative levels of NSE were not associated with POCD at discharge.

Original languageEnglish
JournalJournal of Cardiothoracic and Vascular Anesthesia
ISSN1053-0770
DOIs
Publication statusE-pub ahead of print - 16 May 2021

    Research areas

  • biomarkers, cardiac surgery, cardiopulmonary bypass, cerebral injury, coronary artery bypass grafting, postoperative cognitive dysfunction

ID: 66563332