Brain injury biomarkers do not predict delirium in acutely ill older patients: a prospective cohort study

Abstract

Delirium is a common, serious, and often preventable neuropsychiatric emergency mostly characterized by a disturbance in attention and awareness. Systemic insult and inflammation causing blood–brain-barrier (BBB) damage and glial and neuronal activation leading to more inflammation and cell death is the most accepted theory behind delirium's pathophysiology. This study aims to evaluate the relationship between brain injury biomarkers on admission and delirium in acutely ill older patients. We performed a prospective cohort study which analyzed plasma S100B levels at admission in elderly patients. Our primary outcome was delirium diagnosis. Secondary outcomes were association between S100B, NSE and Tau protein and delirium diagnosis and patients’ outcomes (admissions to intensive care, length of hospital stay, and in-hospital mortality). We analyzed 194 patients, and 46 (24%) developed delirium, 25 on admission and 21 during hospital stay. Median of S100B at admission in patients who developed delirium was 0.16 and median was 0.16 in patients who didn’t develop delirium (p: 0.69). Levels S100B on admission did not predict delirium in acutely ill elderly patients.Trial registration: The study was approved by the local institutional review board (CAPPESq, no. 77169716.2.0000.0068, October 11, 2017) and registered in Brazilian Clinical Trials Registry (ReBEC, no. RBR-233bct).

Alterations in Neurotrophins in Alcohol-Addicted Patients during Alcohol Withdrawal

“…It is a more specific predictor of delirium [ 123 ]. However, S100B levels on admission did not predict delirium in affected elderly patients [ 124 ]. Moreover, mDNA in the neurotrophic genes of GDNF in both the brain and blood increases with age, especially among delirium patients [ 125 ].…”

The role of NSE and Tau proteins in identifying Sepsis-associated Delirium: a cross- sectional pilot study

“…Our study is part of the ongoing Biomarkers and clinical scores in critically ill patients' study, designed to investigate serum biomarkers in older ED patients and their outcomes. [10] We evaluated all older patients admitted with delirium for inclusion in the study. Patients hospitalized for more than 24 hours in any health care facility; previously hospitalized in 30 days preceding admission; expected period of hospitalization less than 48 hours and submitted to end-of-life care were excluded from the study.…”