Low preoperative plasma cholinesterase activity as a risk marker of postoperative delirium in elderly patients
Background: delirium is a frequent neuropsychiatric syndrome affecting medical and surgical elderly patients. Cholinergic dysfunction has been implicated in delirium pathophysiology and plasmatic acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) activities are suppressed in patients with...
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| Published in | Age and ageing Vol. 40; no. 5; pp. 621 - 626 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
Oxford University Press
01.09.2011
Oxford Publishing Limited (England) |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0002-0729 1468-2834 1468-2834 |
| DOI | 10.1093/ageing/afr053 |
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| Abstract | Background: delirium is a frequent neuropsychiatric syndrome affecting medical and surgical elderly patients. Cholinergic dysfunction has been implicated in delirium pathophysiology and plasmatic acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) activities are suppressed in patients with delirium. In this cohort study, we investigated whether these changes emerge during delirium or whether they are present before its onset.
Methods: plasma activities of AChE and BuChE were measured pre- and postoperatively in consecutive patients ≥60 years old undergoing elective total hip replacement surgery. In addition to a comprehensive clinical and demographic baseline evaluation, venous blood samples were collected from each subject in the morning of hospital admission's day and in the morning of the first postoperative day. Delirium was screened daily with confusion assessment method (confirmed with diagnostic and statistical manual of mental disorders (DSM-IV)-TR).
Results: preoperatively, plasma esterase activity was significantly lower in patients who developed delirium compared with the remaining subjects. Following surgery BuChE activity was lower in the delirium group but this difference disappeared after controlling for preoperative values. Plasma cholinesterase activity correlated positively with calcium and haemoglobin and negatively with total bilirubin and international normalised ratio.
Conclusion: plasma cholinesterase activity can be a useful candidate biomarker to identify subjects at greater risk of developing postoperative delirium. |
|---|---|
| AbstractList | Background: delirium is a frequent neuropsychiatric syndrome affecting medical and surgical elderly patients. Cholinergic dysfunction has been implicated in delirium pathophysiology and plasmatic acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) activities are suppressed in patients with delirium. In this cohort study, we investigated whether these changes emerge during delirium or whether they are present before its onset.Methods: plasma activities of AChE and BuChE were measured pre- and postoperatively in consecutive patients greater than or equal to 60 years old undergoing elective total hip replacement surgery. In addition to a comprehensive clinical and demographic baseline evaluation, venous blood samples were collected from each subject in the morning of hospital admission's day and in the morning of the first postoperative day. Delirium was screened daily with confusion assessment method (confirmed with diagnostic and statistical manual of mental disorders (DSM-IV)-TR).Results: preoperatively, plasma esterase activity was significantly lower in patients who developed delirium compared with the remaining subjects. Following surgery BuChE activity was lower in the delirium group but this difference disappeared after controlling for preoperative values. Plasma cholinesterase activity correlated positively with calcium and haemoglobin and negatively with total bilirubin and international normalised ratio.Conclusion: plasma cholinesterase activity can be a useful candidate biomarker to identify subjects at greater risk of developing postoperative delirium. Background: delirium is a frequent neuropsychiatric syndrome affecting medical and surgical elderly patients. Cholinergic dysfunction has been implicated in delirium pathophysiology and plasmatic acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) activities are suppressed in patients with delirium. In this cohort study, we investigated whether these changes emerge during delirium or whether they are present before its onset. Methods: plasma activities of AChE and BuChE were measured pre- and postoperatively in consecutive patients ≥60 years old undergoing elective total hip replacement surgery. In addition to a comprehensive clinical and demographic baseline evaluation, venous blood samples were collected from each subject in the morning of hospital admission's day and in the morning of the first postoperative day. Delirium was screened daily with confusion assessment method (confirmed with diagnostic and statistical manual of mental disorders (DSM-IV)-TR). Results: preoperatively, plasma esterase activity was significantly lower in patients who developed delirium compared with the remaining subjects. Following surgery BuChE activity was lower in the delirium group but this difference disappeared after controlling for preoperative values. Plasma cholinesterase activity correlated positively with calcium and haemoglobin and negatively with total bilirubin and international normalised ratio. Conclusion: plasma cholinesterase activity can be a useful candidate biomarker to identify subjects at greater risk of developing postoperative delirium. Delirium is a frequent neuropsychiatric syndrome affecting medical and surgical elderly patients. Cholinergic dysfunction has been implicated in delirium pathophysiology and plasmatic acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) activities are suppressed in patients with delirium. Here, Cerejeira investigate whether these changes emerge during delirium or whether they are present before its onset. Results show that plasma cholinesterase activity can be a useful candidate biomarker to identify subjects at greater risk of developing postoperative delirium. Background: delirium is a frequent neuropsychiatric syndrome affecting medical and surgical elderly patients. Cholinergic dysfunction has been implicated in delirium pathophysiology and plasmatic acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) activities are suppressed in patients with delirium. In this cohort study, we investigated whether these changes emerge during delirium or whether they are present before its onset. Methods: plasma activities of AChE and BuChE were measured pre- and postoperatively in consecutive patients >=60 years old undergoing elective total hip replacement surgery. In addition to a comprehensive clinical and demographic baseline evaluation, venous blood samples were collected from each subject in the morning of hospital admission's day and in the morning of the first postoperative day. Delirium was screened daily with confusion assessment method (confirmed with diagnostic and statistical manual of mental disorders (DSM-IV)-TR). Results: preoperatively, plasma esterase activity was significantly lower in patients who developed delirium compared with the remaining subjects. Following surgery BuChE activity was lower in the delirium group but this difference disappeared after controlling for preoperative values. Plasma cholinesterase activity correlated positively with calcium and haemoglobin and negatively with total bilirubin and international normalised ratio. Conclusion: plasma cholinesterase activity can be a useful candidate biomarker to identify subjects at greater risk of developing postoperative delirium. Adapted from the source document. delirium is a frequent neuropsychiatric syndrome affecting medical and surgical elderly patients. Cholinergic dysfunction has been implicated in delirium pathophysiology and plasmatic acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) activities are suppressed in patients with delirium. In this cohort study, we investigated whether these changes emerge during delirium or whether they are present before its onset.BACKGROUNDdelirium is a frequent neuropsychiatric syndrome affecting medical and surgical elderly patients. Cholinergic dysfunction has been implicated in delirium pathophysiology and plasmatic acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) activities are suppressed in patients with delirium. In this cohort study, we investigated whether these changes emerge during delirium or whether they are present before its onset.plasma activities of AChE and BuChE were measured pre- and postoperatively in consecutive patients ≥60 years old undergoing elective total hip replacement surgery. In addition to a comprehensive clinical and demographic baseline evaluation, venous blood samples were collected from each subject in the morning of hospital admission's day and in the morning of the first postoperative day. Delirium was screened daily with confusion assessment method (confirmed with diagnostic and statistical manual of mental disorders (DSM-IV)-TR).METHODSplasma activities of AChE and BuChE were measured pre- and postoperatively in consecutive patients ≥60 years old undergoing elective total hip replacement surgery. In addition to a comprehensive clinical and demographic baseline evaluation, venous blood samples were collected from each subject in the morning of hospital admission's day and in the morning of the first postoperative day. Delirium was screened daily with confusion assessment method (confirmed with diagnostic and statistical manual of mental disorders (DSM-IV)-TR).preoperatively, plasma esterase activity was significantly lower in patients who developed delirium compared with the remaining subjects. Following surgery BuChE activity was lower in the delirium group but this difference disappeared after controlling for preoperative values. Plasma cholinesterase activity correlated positively with calcium and haemoglobin and negatively with total bilirubin and international normalised ratio.RESULTSpreoperatively, plasma esterase activity was significantly lower in patients who developed delirium compared with the remaining subjects. Following surgery BuChE activity was lower in the delirium group but this difference disappeared after controlling for preoperative values. Plasma cholinesterase activity correlated positively with calcium and haemoglobin and negatively with total bilirubin and international normalised ratio.plasma cholinesterase activity can be a useful candidate biomarker to identify subjects at greater risk of developing postoperative delirium.CONCLUSIONplasma cholinesterase activity can be a useful candidate biomarker to identify subjects at greater risk of developing postoperative delirium. delirium is a frequent neuropsychiatric syndrome affecting medical and surgical elderly patients. Cholinergic dysfunction has been implicated in delirium pathophysiology and plasmatic acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) activities are suppressed in patients with delirium. In this cohort study, we investigated whether these changes emerge during delirium or whether they are present before its onset. plasma activities of AChE and BuChE were measured pre- and postoperatively in consecutive patients ≥60 years old undergoing elective total hip replacement surgery. In addition to a comprehensive clinical and demographic baseline evaluation, venous blood samples were collected from each subject in the morning of hospital admission's day and in the morning of the first postoperative day. Delirium was screened daily with confusion assessment method (confirmed with diagnostic and statistical manual of mental disorders (DSM-IV)-TR). preoperatively, plasma esterase activity was significantly lower in patients who developed delirium compared with the remaining subjects. Following surgery BuChE activity was lower in the delirium group but this difference disappeared after controlling for preoperative values. Plasma cholinesterase activity correlated positively with calcium and haemoglobin and negatively with total bilirubin and international normalised ratio. plasma cholinesterase activity can be a useful candidate biomarker to identify subjects at greater risk of developing postoperative delirium. |
| Audience | Academic |
| Author | Batista, Pedro Firmino, Horácio Cerejeira, Joaquim Vaz-Serra, Adriano Mukaetova-Ladinska, Elizabeta B. Nogueira, Vasco |
| Author_xml | – sequence: 1 givenname: Joaquim surname: Cerejeira fullname: Cerejeira, Joaquim email: jcerejeira@netcabo.pt organization: 1 Serviço de Psiquiatria, Hospitais da Universidade de Coimbra, Coimbra 3000-377, Portugal – sequence: 2 givenname: Pedro surname: Batista fullname: Batista, Pedro organization: 1 Serviço de Psiquiatria, Hospitais da Universidade de Coimbra, Coimbra 3000-377, Portugal – sequence: 3 givenname: Vasco surname: Nogueira fullname: Nogueira, Vasco organization: 1 Serviço de Psiquiatria, Hospitais da Universidade de Coimbra, Coimbra 3000-377, Portugal – sequence: 4 givenname: Horácio surname: Firmino fullname: Firmino, Horácio organization: 1 Serviço de Psiquiatria, Hospitais da Universidade de Coimbra, Coimbra 3000-377, Portugal – sequence: 5 givenname: Adriano surname: Vaz-Serra fullname: Vaz-Serra, Adriano organization: 2 Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal – sequence: 6 givenname: Elizabeta B. surname: Mukaetova-Ladinska fullname: Mukaetova-Ladinska, Elizabeta B. organization: 3 Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/21576115$$D View this record in MEDLINE/PubMed |
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| Snippet | Background: delirium is a frequent neuropsychiatric syndrome affecting medical and surgical elderly patients. Cholinergic dysfunction has been implicated in... delirium is a frequent neuropsychiatric syndrome affecting medical and surgical elderly patients. Cholinergic dysfunction has been implicated in delirium... Delirium is a frequent neuropsychiatric syndrome affecting medical and surgical elderly patients. Cholinergic dysfunction has been implicated in delirium... |
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| SubjectTerms | Acetylcholinesterase - blood Age Factors Aged Aged patients Aged, 80 and over Aging - blood Arthroplasty, Replacement, Hip - adverse effects Bilirubin - blood Biological markers Biomarkers Biomarkers - blood Butyrylcholinesterase - blood Calcium - blood Candidates Care and treatment Chi-Square Distribution Cohort analysis Delirium Delirium - blood Delirium - diagnosis Delirium - etiology Down-Regulation Elderly patients Elective Surgical Procedures Female Genetic aspects Haemoglobin Hemoglobins - metabolism Humans International Normalized Ratio Male Middle Aged Older people Pathophysiology Perioperative care Plasma Portugal Postoperative period Preoperative Prospective Studies Psychiatric Status Rating Scales Sick elderly people Surgery Time Factors Treatment Outcome |
| Title | Low preoperative plasma cholinesterase activity as a risk marker of postoperative delirium in elderly patients |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/21576115 https://www.proquest.com/docview/893418338 https://www.proquest.com/docview/883307432 https://www.proquest.com/docview/899163431 https://www.proquest.com/docview/902097057 |
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