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Role of Blood–Brain Barrier Dysfunction in Delirium following Non‐cardiac Surgery in Older Adults by Michael J. Devinney; Megan K. Wong; Mary Cooter Wright; Edward R. Marcantonio; Niccolò Terrando; Jeffrey N. Browndyke; Heather E. Whitson; Harvey J. Cohen; Andrea G. Nackley; Marguerita E. Klein; E. Wesley Ely; Joseph P. Mathew; Miles Berger; for the MADCO‐PC and INTUIT Study Teams is a Medicine article available to read on EtoBox.
What is Role of Blood–Brain Barrier Dysfunction in Delirium following Non‐cardiac Surgery in Older Adults about?
## Objective Although animal models suggest a role for blood–brain barrier dysfunction in postoperative delirium‐like behavior, its role in postoperative delirium and postoperative recovery in humans is unclear. Thus, we evaluated the role of blood–brain barrier dysfunction in postoperative delirium and hospital length of stay among older surgery patients. ## Methods Cognitive testing, delirium assessment, and cerebrospinal fluid and blood sampling were prospectively performed before and after non‐cardiac, non‐neurologic surgery. Blood–brain barrier dysfunction was assessed using the cerebrospinal fluid‐to‐plasma albumin ratio (CPAR). ## Results Of 207 patients (median age = 68 years, 45% female) with complete CPAR and delirium data, 26 (12.6%) developed postoperative delirium. Overall, CPAR increased from before to 24 hours after surgery (median change = 0.28, interquartile range [IQR] = −0.48 to 1.24, Wilcoxon *p* = 0.001). Preoperative to 24 hours postoperative change in CPAR was greater among patients who developed delirium versus those who did not (median [IQR] = 1.31 [0.004 to 2.34] vs 0.19 [−0.55 to 1.08], *p* = 0.003). In a multivariable model adjusting for age, baseline co
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- Author
- Michael J. Devinney; Megan K. Wong; Mary Cooter Wright; Edward R. Marcantonio; Niccolò Terrando; Jeffrey N. Browndyke; Heather E. Whitson; Harvey J. Cohen; Andrea G. Nackley; Marguerita E. Klein; E. Wesley Ely; Joseph P. Mathew; Miles Berger; for the MADCO‐PC and INTUIT Study Teams
- Publisher
- Wiley
- Published
- 2023
- Field
- Medicine (Health Sciences)