Department of Anesthesia and Pain, The Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Orthopedics, The Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Brain Behav. 2019 Jan;9(1):e01176. doi: 10.1002/brb3.1176. Epub 2018 Dec 11.
Brain injury is implicated in pathogenesis of postoperative delirium (POD) and cognitive dysfunction (POCD). S100A12 is involved in inflammatory process and is recently known as a biomarker for brain injury. Herein, we clarified whether serum S100A12 levels are related to POD and POCD after hip fracture surgery in elderly patients.
In this prospective, observational study, we gauged S100A12 levels in preoperative and postoperative serum from 186 patients and serum from 186 controls. Patients were categorized according to the presence of POD and POCD.
Postoperative, but not preoperative serum S100A12 levels were significantly higher in patients than in controls. There was a positive and independent correlation between postoperative C-reactive protein and S100A12 levels (t = 8.797, p < 0.001). Postoperative S10012 levels and age were independently associated with the risk of developing POD (S100A12 levels: odds ratio [OR] = 1.166, 95% confidence interval [CI] = 1.045-2.087, p = 0.001; age: OR = 1.243, 95% CI = 1.073-1.419, p = 0.012) and POCD (S100A12: OR = 1.157, 95% CI = 1.030-1.986, p = 0.003; age: OR = 1.228, 95% CI = 1.054-1.387, p = 0.014). In terms of area under receiver operating characteristic curve, postoperative S100A12 levels had a higher predictive ability than age and their combination dramatically exceeded that of each one alone.
Postoperative elevated serum S100A12 levels have a strong relation to inflammation and are associated independently with the development of POD and POCD, substantializing serum S100A12 as a potential biomarker for predicting POD and POCD in elderly patients undergoing hip fracture surgery.
脑损伤与术后谵妄（POD）和认知功能障碍（POCD）的发病机制有关。S100A12 参与炎症过程，最近被认为是脑损伤的生物标志物。在此，我们阐明了血清 S100A12 水平是否与老年髋部骨折患者术后 POD 和 POCD 有关。
在这项前瞻性观察研究中，我们测量了 186 例患者术前和术后及 186 例对照者血清中的 S100A12 水平。根据 POD 和 POCD 的发生情况对患者进行分类。
与对照组相比，患者术后但术前血清 S100A12 水平显著升高。术后 C 反应蛋白与 S100A12 水平呈正相关且独立（t=8.797，p<0.001）。术后 S100A12 水平和年龄与 POD 发生的风险独立相关（S100A12 水平：比值比[OR]为 1.166，95%置信区间[CI]为 1.045-2.087，p=0.001；年龄：OR 为 1.243，95%CI 为 1.073-1.419，p=0.012）和 POCD（S100A12：OR 为 1.157，95%CI 为 1.030-1.986，p=0.003；年龄：OR 为 1.228，95%CI 为 1.054-1.387，p=0.014）。在接受者操作特征曲线的面积方面，术后 S100A12 水平的预测能力高于年龄，两者的组合显著优于单独使用每一个指标。
术后血清 S100A12 水平升高与炎症密切相关，与 POD 和 POCD 的发生独立相关，证实了血清 S100A12 作为预测老年髋部骨折患者术后 POD 和 POCD 的潜在生物标志物的可能性。
