Biomarkers and postoperative cognitive function: could it be that easy?
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Biomarkers and postoperative cognitive function: could it be that easy? / Schaefer, Simon T; Koenigsperger, Stephan; Olotu, Cynthia; Saller, Thomas.
in: CURR OPIN ANESTHESIO, Jahrgang 32, Nr. 1, 02.2019, S. 92-100.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung
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TY - JOUR
T1 - Biomarkers and postoperative cognitive function: could it be that easy?
AU - Schaefer, Simon T
AU - Koenigsperger, Stephan
AU - Olotu, Cynthia
AU - Saller, Thomas
PY - 2019/2
Y1 - 2019/2
N2 - PURPOSE OF REVIEW: Neurocognitive dysfunction after surgery is highly relevant in the elderly. The multifactorial manner of this syndrome has made it hard to define an ideal biomarker to predict individual risk and assess diagnosis and severity of delirium [postoperative delirium (POD)] and subsequent postoperative cognitive decline (POCD). This review summarizes recent literature on blood biomarkers for POD/POCD.RECENT FINDINGS: Markers for delirium have been searched for in the cerebrospinal fluid to examine the pathologic cascade. However, cerebrospinal fluid cannot be easily obtained in the perioperative setting. Thus, attention shifts toward prediction markers from patients' blood to determine the individual risk. In this regard, three major groups of peripheral blood markers could be distinguished: first, global, but unspecific markers associated with POD/POCD; second, specific and established markers related to neurocognitive function; and third, upcoming or newly described markers with less evidence. Solely neuron-specific enolase is an adequate biomarker based on recent literature.SUMMARY: Single markers for postoperative cognitive impairment cannot predict POD/POCD in geriatric patients. However, a wisely arranged battery of promising biomarkers might achieve a satisfying sensitivity and specificity for the preoperative assessment of subsequent cognitive decline. Adequately powered studies to prove this hypothesis are required.
AB - PURPOSE OF REVIEW: Neurocognitive dysfunction after surgery is highly relevant in the elderly. The multifactorial manner of this syndrome has made it hard to define an ideal biomarker to predict individual risk and assess diagnosis and severity of delirium [postoperative delirium (POD)] and subsequent postoperative cognitive decline (POCD). This review summarizes recent literature on blood biomarkers for POD/POCD.RECENT FINDINGS: Markers for delirium have been searched for in the cerebrospinal fluid to examine the pathologic cascade. However, cerebrospinal fluid cannot be easily obtained in the perioperative setting. Thus, attention shifts toward prediction markers from patients' blood to determine the individual risk. In this regard, three major groups of peripheral blood markers could be distinguished: first, global, but unspecific markers associated with POD/POCD; second, specific and established markers related to neurocognitive function; and third, upcoming or newly described markers with less evidence. Solely neuron-specific enolase is an adequate biomarker based on recent literature.SUMMARY: Single markers for postoperative cognitive impairment cannot predict POD/POCD in geriatric patients. However, a wisely arranged battery of promising biomarkers might achieve a satisfying sensitivity and specificity for the preoperative assessment of subsequent cognitive decline. Adequately powered studies to prove this hypothesis are required.
KW - Journal Article
KW - Severity of Illness Index
KW - Anesthesia/adverse effects
KW - Predictive Value of Tests
KW - Prognosis
KW - Age Factors
KW - Biomarkers/analysis
KW - Humans
KW - Postoperative Period
KW - Cognitive Dysfunction/diagnosis
KW - Feasibility Studies
KW - Aging/physiology
KW - Emergence Delirium/diagnosis
KW - Surgical Procedures, Operative/adverse effects
KW - Cognition/drug effects
KW - Sensitivity and Specificity
KW - Aged
U2 - 10.1097/ACO.0000000000000676
DO - 10.1097/ACO.0000000000000676
M3 - SCORING: Review article
C2 - 30507679
VL - 32
SP - 92
EP - 100
JO - CURR OPIN ANESTHESIO
JF - CURR OPIN ANESTHESIO
SN - 0952-7907
IS - 1
ER -