Markers of cerebral damage during delirium in elderly patients with hip fracture

Munster, Barbara C. Van; Korse, Catharina M.; Rooij, Sophia E. J. A. de; Bonfrèr, Johannes M.G.; Zwinderman, Aeilko H.; Korevaar, Johanna C.

doi:10.1186/1471-2377-9-21

Cited by 96 publications

(81 citation statements)

References 37 publications

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“…S100B reflects extent of brain injury, and C-reactive protein is a marker of inflammation. A growing body of evidence has shown that S100B and C-reactive protein levels in peripheral blood can identify patients at risk of delirium (Dillon et al, 2017;Hall et al, 2013;van Munster, Bisschop, et al, 2010;van Munster et al, 2009). The current study also demonstrated that serum S100B and C-reactive protein levels were the independent predictors for delirium among postpartum women in ICU.…”

Section: Discussionsupporting

confidence: 66%

“…In this study, incidence of delirium within 7 days after ICU entry was 20.6% among postpartum women. Although the mechanisms underlying delirium were unknown, the accumulating evidence indicates that brain injury (Hall et al, 2013;van Munster, Bisschop, et al, 2010;van Munster et al, 2009) and inflammation (Cerejeira et al, 2010(Cerejeira et al, , 2012Dillon et al, 2017) might be involved in this process. Consistent with this statement, we also found that serum S100B and C-reactive protein levels were obviously elevated in postpartum ICU women, especially in delirium women.…”

Section: Discussionmentioning

confidence: 99%

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Serum galectin‐3 levels and delirium among postpartum intensive care unit women

Zhu

et al. 2017

Brain and Behavior

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Objective: Inflammation correlates with delirium. Galectin-3 is a proinflammatory protein. This study aimed to determine relation of serum galectin-3 levels to delirium of postpartum intensive care unit (ICU) women. Materials and Methods:In this prospective observational study, serum galectin-3, S100B, and C-reactive protein levels of 412 postpartum ICU women and 412 healthy women were measured. Delirium and Acute Physiology and Chronic Health Care Evaluation II (APCHCE II) scores were recorded.Results: Serum levels of galectin-3, S100B, and C-reactive protein were significantly elevated in the postpartum women than in the healthy women. Galectin-3 levels were highly associated with APCHCE II scores and S100B and C-reactive protein levels.Galectin-3, C-reactive protein, and S100B levels and APCHCE II scores were identified as independent predictors for delirium. Area under the curve (AUC) of serum galectin-3 levels was similar to that of S100B levels, and significantly exceeded those of Creactive protein levels and APCHCE II scores. Moreover, galectin-3 significantly improved the AUCs of APCHCE II scores, S100B levels, and C-reactive protein levels. Conclusions:Galectin-3, involved in inflammatory process underlying delirium-related brain injury, might be a potential biomarker to predict delirium of postpartum ICU women. K E Y W O R D Sdelirium, galectin-3, intensive care unit, postpartum, women

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Serum galectin‐3 levels and delirium among postpartum intensive care unit women

Zhu

et al. 2017

Brain and Behavior

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“…The hip fracture studies that met the inclusion criteria are presented in Table 1. [3], N = 120 52% Age, gender, cognitive*,physical impairment, polymedicine, IL-6,IL-8, length of stay Juliebo et al 2009 [29], N = 364 58% Age, gender*, cognitive*, function*impairment, 21% preop comorbidity, health problem, BMI*, hemoglobin* 36.4% postop sodium, potassium, BUN/Cr ratio, polypharmacy*, Arrhythmia, medication use (psychotropic, selective serotonin reuptake inhibitor, zopiclone, aspirin, betablocker, diuretic, statin) fentanyl* Juliebo et al 2010 [30], N = 331 43.2% Kat et al 2011 [31], N = 603 12.3% postop Bisschop et al 2011 [32], N = 143 34% Age*, gender, preexisting cognitive* and functional* impairment, comorbidity*, laboratory abnormalities*, glucose Lee et al 2011 [33], N = 232 30.2% Age, gender, comorbidity, health problem*, BMI Vochteloo et al 2011 [34], N = 378 27% Age*, gender*,dementia, health problem*, psychotropic drug use*, length of stay* Sieber et al 2011 [35], N = 236…”

Section: Resultsmentioning

confidence: 99%

“…Delirium is defined conceptually as "a disturbance of consciousness with inattention accompanied by a change in cognition or perceptual disturbance that develops over a short period of time (hour to days) and fluctuates over time" [2]. Episodes of delirium are associated with longer hospital stays and greater morbidity and mortality [3], cause considerable distress to patients and families, and is expensive [4]. A useful predictive model for the development of delirium in elderly hospitalized patients [5] suggests that delirium is precipitated when the sum of predisposing and precipitating factors crosses a certain threshold.…”

mentioning

confidence: 99%

Risk factors of delirium in elderly patients with hip fracture

Suwanpasu

Grinslade

et al. 2014

Asian Biomedicine

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Background: Delirium is a leading cause of death and disability in the elderly with hip fracture. Identifying reliable risk factors for delirium is critical to support optimal outcomes for prevention and reducing delirium. Objective: To quantify the reported factors associated to delirium for patients with hip fracture. Methods: Electronic databases were searched (including Medline, Pub Med, CINAHL, EMBASE, Evidence Based Medicine Reviews, Cochrane Review, Web of Science, and PsycINFO) to identify all studies, published in English language that evaluated the risk factors of delirium hospitalized people with hip fracture. Two reviewers independently assessed methodology quality and extracted relevant data. The data from the included studies were summarized, and pooled estimates were calculated for 12 risk factors. Results: Thirty-seven studies were included in the review and 25 in the meta-analysis. The incidence of delirium was 32.4% (95% confidence interval [CI] = 25.9%-39.5%). Six predisposing and four precipitating factors predicted delirium among older patients with hip fracture confirmed. The predisposing factors included advanced age (ES = 1.06, 95% CI = 1.03-1.09), male sex (ES = 1.34, 95% CI = 1.08-1.68), impairment of cognition (ES = 2.91, 95% CI = 1.91-4.42), and function (ES = 1.75, 95% CI = 1.39-2.2), comorbidity (ES = 1.59, 95% CI = 1.30-1.96), and health problems (ES = 2.64, 95% CI = 2.04-3.42). Precipitating factors were hypo-or hypernatremia (ES = 1.73, 95% CI = 1.14-2.64), depression (ES = 4.07, 95% CI = 1.95-8.49), more than three prescribed drugs (ES = 1.28, 95% CI = 1.10-1.49), and drugs including opioids (ES = 2.13, 95% CI = 1.42-3.18) and anticholinergic agents (ES = 2.10, 95% CI = 1.60-2.75). Conclusion:This meta-analysis result provides evidence that these risk factors have a significant impact on delirium in elders with hip fracture during hospitalization. Developing formal screening, and effective preventive and management strategies for delirium is important.

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“…Elevated levels of S100B have been shown to be associated with delirium in patients after abdominal surgery [13], cardiac surgery [14], hip fracture surgery [15] and in sepsis-related delirium [16].…”

Section: Introductionmentioning

confidence: 99%

S100B and delirium in the geriatric acute care setting

Aly¹,

Abdul–Rahman²,

Said³

et al. 2014

AAR

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Delirium and its relation to biochemical markers have been considered a study question in several research works. The relation between S100B levels and delirium is still a matter of discussion. Objective: To compare the serum level of S100B in patients with and without delirium and to detect the relation between S100B and delirium subtypes. Method: A case control study was conducted on 114 elderly (60 years and older) selected from the geriatric acute care unit at Ain Shams University Hospitals. They were classified into two groups; 58 elderly cases who had delirium diagnosed by Confusion Assessment Method and 56 controls. Then delirium was reclassified according to the subtypes of delirium into Hyperactive: 46 patients, hypoactive: 2 patients, and Mixed: 10 patients. Serum S100B levels were determined by ELISA. Results: Cases were significantly older than controls (72.4 ± 9.4 versus 66.9 ± 5.3 years respectively) (P < 0.001). S100B levels were higher in cases (32.4 ± 9.8 pg/ml) than controls (30 ± 9.3 pg/ml) but the difference was not statistically significant (P = 0.19). There was no significant difference in S100B levels between the different subtypes of delirium. Conclusion: Delirious patients had higher S100B levels than controls but the difference was not statistically significant.

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Markers of cerebral damage during delirium in elderly patients with hip fracture

Cited by 96 publications

References 37 publications

Serum galectin‐3 levels and delirium among postpartum intensive care unit women

Serum galectin‐3 levels and delirium among postpartum intensive care unit women

Risk factors of delirium in elderly patients with hip fracture

S100B and delirium in the geriatric acute care setting

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