Correlation Between Plasma CircRNA-089763 and Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Non-cardiac Surgery

Abstract

In our previous experiment, we found that there were abnormal levels of circRNA-089763 in the plasma exosomes of patients with postoperative cognitive dysfunction (POCD) after cardiac surgery. Therefore, the aim of this study was to further investigate the relationship between plasma circRNA-089763 level and POCD in elderly patients after non-cardiac surgery. A prospective cohort study was conducted to select elderly patients undergoing elective non-cardiac surgery. A total of 72 patients were enrolled in this study, and cognitive functions were assessed 1 day before and 3 days after surgery by a series of neuropsychological measurements. Next, patients were divided into POCD and non-POCD (NPOCD) groups according to the Z score method. Blood was collected the day before and 3 days after surgery, and the plasma circRNA-089763 level was detected by quantitative real-time polymerase chain reaction (qRT-PCR). Then, the difference and correlation in plasma circRNA-089763 levels between the POCD and NPOCD groups were analyzed. On the third day after surgery, the incidence of POCD was 30.56%. The relative level of circRNA-089763 in the POCD group was 2.41 times higher than that in the NPOCD group ( t = 4.711, p < 0.001), patients in POCD group had higher age ( t = 5.971, p < 0.001), higher American Society of Anesthesiologists classification (χ 2 = 14.726, p < 0.001), less years of education ( t = 2.449, p = 0.017), more intraoperative blood loss ( t = 3.196, p = 0.002), and higher visual analog scale (VAS) scores ( t = 10.45, p < 0.001). The binary logistic regression analysis showed that the circRNA-089763 level, age, and intraoperative blood loss were independently associated with POCD (OR: 2.75, 95% CI: 1.261–5.999, p = 0.011; OR: 1.32, 95% CI: 1.114–1.565, p = 0.001; OR: 1.017, 95% CI: 1.004–1.03, p = 0.011). These results demonstrated that the circRNA-089763 plasma level was related to POCD after non-cardiac surgery in elderly patients.

Early Cognitive Dysfunction in Elderly Patients after Total Knee Arthroplasty: An Analysis of Risk Factors and Cognitive Functional Levels

“…Blood loss, including postoperative oozing, as reflected by reduced hemoglobin levels, might render a patient susceptible to a higher risk of POCD in the present study. The conclusion that the occurrence of cognitive dysfunction is affected by intraoperative blood loss in elderly patients has consistently been confirmed [21,22]. A deficiency in oxygen supply to the brain may result in cognitive dysfunction, which may explain the association between low hemoglobin levels and POCD [23].…”

Post-Operative Cognitive Impairment: A Cognitive Epidemiology Perspective

“…To name one landmark study included in the meta-analysis, the International Study of Post-Operative Cognitive Dysfunction (ISPOCD 1), found that among 1011 older surgical patients recruited in eight European countries and the USA, patients with more than a high school education had even a halved risk of POCD at one week after surgery compared with patients with less than high school education ( Moller et al 1998 ). Studies from various European and Asian countries and the USA that were not included in the 2017 meta-analysis ( Grichnik et al 1999 ) or published thereafter ( Bendikaite and Vimantaite 2020 ; Ehsani et al 2020 ; Huang et al 2020a ; Klinger et al 2019 ; Li et al 2020 ; Wang et al 2018 ; Yuhe et al 2020 ; Zhang et al 2019 ; Zhou et al 2020 ) too, consistently indicate that patients with a lower educational level are at increased POCD risk at discharge ( Zhang et al 2019 ) within days of surgery ( Ehsani et al 2020 ; Li et al 2020 ; Zhao et al 2020 ; Zhou et al 2020 ) but also during six to 12 weeks after surgery ( Grichnik et al 1999 ; Yuhe et al 2020 ). The fact that observations extend to several months after surgery is important because studies on POCD with longer follow-up periods offer preferred scope for conclusions: during shorter follow-up periods immediate effects of surgery on brain function including a potential influence of POD can prevail.…”

Noncoding RNAs: Novel Insights into Postoperative Neurocognitive Disorders

“…24 While cognitive function of POCD patients with higher levels of hsa-miR-572 in the peripheral blood was not recovered after surgery, 27 higher levels of plasma hsa-circR-089763 were related to the incidence of POCD in elderly patients undergoing noncardiac surgery. 41 3.5. ncRNAs as for Mechanisms of POCD. The novel mechanisms in terms of classical "circRNA/lncRNA− miRNA−mRNA" axes including lncRNA HOTAIR-Bdnf, 40 circ-Shank3-miR-3569-Fkbp5/Lrrc32, 29 and miR-206-IGF-1 30 were involved in the development of POCD.…”