Serum HMGB1 as a predictor for postoperative delirium in elderly patients undergoing total hip arthroplasty surgery.

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Advances in Clinical and Experimental Medicine Pub Date : 2024-08-29 DOI:10.17219/acem/189227

Yan Zou, Yuan Wu, An Wei, Hao Nie, Shan Hui, Cuizhong Liu, Tingzhi Deng

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Abstract

Background: Postoperative delirium (POD) is an acute mental disorder that occurs after surgery requiring general anesthesia. In animal studies, high-mobility group box 1 (HMGB1) plays a key role in mediating postoperative neuroinflammation and may have a direct impact on POD.

Objectives: The objective of this prospective observational study was to investigate the serum levels of HMGB1 in elderly POD patients undergoing total hip arthroplasty.

Material and methods: This prospective observational study included 287 elderly patients who underwent total hip arthroplasty in our hospital from October 2019 to September 2022. Patients were assessed for the presence of POD using the Confusion Assessment Method (CAM) within 72 h of surgery. Serum HMGB1, interleukin (IL)-6, IL-1β, tumor necrosis factor alpha (TNF-α), and C-reactive protein (CRP) levels were measured using enzyme-linked immunosorbent assay (ELISA) before surgery, as well as at 24 h, 48 h and 72 h after surgery. Demographic and clinical data of all elderly patients were collected.

Results: The anesthesia time and surgical time in the POD group were significantly higher than those in the non-POD group. The serum levels of HMGB1, IL-6 and IL-1β in the POD group were significantly elevated compared to those in the non-POD group at all time points after surgery (p < 0.05). In addition, the serum levels of HMGB1 were positively correlated with TNF-α, IL-6 and IL-1β levels. HMGB1, IL-6 and IL-1β could be potential predictive biomarkers for the occurrence of POD in elderly patients undergoing total hip arthroplasty. Finally, we found that anesthesia time, surgical time, HMGB1, TNF-α, IL-6, and IL-1β were risk factors for POD in elderly patients undergoing total hip arthroplasty.

Conclusions: Serum HMGB1 levels were markedly elevated in elderly POD patients undergoing total hip arthroplasty. In addition, HMGB1 could serve as a potential predictive biomarker for POD in elderly patients undergoing total hip arthroplasty.

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血清 HMGB1 作为接受全髋关节置换手术的老年患者术后谵妄的预测因子。

背景：术后谵妄（POD）是一种急性精神障碍，发生在需要全身麻醉的手术之后。在动物实验中，高迁移率基团框 1（HMGB1）在介导术后神经炎症中起着关键作用，可能对 POD 有直接影响：本前瞻性观察研究旨在调查接受全髋关节置换术的老年 POD 患者血清中的 HMGB1 水平：这项前瞻性观察研究纳入了2019年10月至2022年9月在我院接受全髋关节置换术的287名老年患者。患者在手术后 72 小时内使用意识障碍评估法（CAM）评估是否存在 POD。在手术前、手术后24小时、48小时和72小时使用酶联免疫吸附试验（ELISA）检测血清HMGB1、白细胞介素（IL）-6、IL-1β、肿瘤坏死因子α（TNF-α）和C反应蛋白（CRP）水平。收集了所有老年患者的人口统计学和临床数据：结果：POD 组的麻醉时间和手术时间明显高于非 POD 组。术后各时间点，POD 组血清中 HMGB1、IL-6 和 IL-1β 水平均明显高于非 POD 组（P < 0.05）。此外，血清中 HMGB1 水平与 TNF-α、IL-6 和 IL-1β 水平呈正相关。HMGB1、IL-6和IL-1β可能是预测老年全髋关节置换术患者POD发生的潜在生物标志物。最后，我们发现麻醉时间、手术时间、HMGB1、TNF-α、IL-6 和 IL-1β 是老年全髋关节置换术患者 POD 的风险因素：结论：接受全髋关节置换术的老年 POD 患者血清 HMGB1 水平明显升高。结论：接受全髋关节置换术的老年 POD 患者血清 HMGB1 水平明显升高，此外，HMGB1 可作为接受全髋关节置换术的老年患者 POD 的潜在预测生物标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Clinical and Experimental Medicine MEDICINE, RESEARCH & EXPERIMENTAL-

CiteScore

3.70

自引率

4.80%

发文量

153

审稿时长

6-12 weeks

期刊介绍： Advances in Clinical and Experimental Medicine has been published by the Wroclaw Medical University since 1992. Establishing the medical journal was the idea of Prof. Bogumił Halawa, Chair of the Department of Cardiology, and was fully supported by the Rector of Wroclaw Medical University, Prof. Zbigniew Knapik. Prof. Halawa was also the first editor-in-chief, between 1992-1997. The journal, then entitled "Postępy Medycyny Klinicznej i Doświadczalnej", appeared quarterly. Prof. Leszek Paradowski was editor-in-chief from 1997-1999. In 1998 he initiated alterations in the profile and cover design of the journal which were accepted by the Editorial Board. The title was changed to Advances in Clinical and Experimental Medicine. Articles in English were welcomed. A number of outstanding representatives of medical science from Poland and abroad were invited to participate in the newly established International Editorial Staff. Prof. Antonina Harłozińska-Szmyrka was editor-in-chief in years 2000-2005, in years 2006-2007 once again prof. Leszek Paradowski and prof. Maria Podolak-Dawidziak was editor-in-chief in years 2008-2016. Since 2017 the editor-in chief is prof. Maciej Bagłaj. Since July 2005, original papers have been published only in English. Case reports are no longer accepted. The manuscripts are reviewed by two independent reviewers and a statistical reviewer, and English texts are proofread by a native speaker. The journal has been indexed in several databases: Scopus, Ulrich’sTM International Periodicals Directory, Index Copernicus and since 2007 in Thomson Reuters databases: Science Citation Index Expanded i Journal Citation Reports/Science Edition. In 2010 the journal obtained Impact Factor which is now 1.179 pts. Articles published in the journal are worth 15 points among Polish journals according to the Polish Committee for Scientific Research and 169.43 points according to the Index Copernicus. Since November 7, 2012, Advances in Clinical and Experimental Medicine has been indexed and included in National Library of Medicine’s MEDLINE database. English abstracts printed in the journal are included and searchable using PubMed http://www.ncbi.nlm.nih.gov/pubmed.