Dual-threshold plasma Aβ oligomerization for postoperative delirium risk stratification.
Background Postoperative delirium is common in older surgical patients, but simple blood tests to identify risk are lacking. Plasma amyloid-β oligomers measured by multimer detection (MDS-OAβ) may reflect neurodegenerative vulnerability. Methods We enrolled 101 patients aged ≥65 years undergoing ele...
| Publicado en: | Age & Ageing Vol. 55; no. 4; pp. 1 - 10 |
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| Autores principales: | , , |
| Formato: | Artículo |
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Oxford University Press / USA
Apr2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=193500100&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 193500100 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Apr2026 vid: 55 iid: 4 pid: 622 pub: Oxford University Press / USA artinfo: ui: 193500100 10.1093/ageing/afag106 ppf: 1 ppct: 9 formats: tig: atl: Dual-threshold plasma Aβ oligomerization for postoperative delirium risk stratification. aug: au: Yang, YoungSoon Jung, Ki Jin Kwak, Yong Tae affil: Department of Neurology, Soonchunhyang University, Cheonan-si, Chungcheongnam-do 31151, Korea Department of Orthopedic Surgery, Soonchunhyang University, Cheonan-si, Chungcheongnam-do 31151, Korea Department of Neurology, Hyoja Geriatric Hospital, 1-30, Jungbu-daero 874beon-gil, Giheung-gu, Yongin-si, Gyeonggi-do 17089, Korea su: South Korea Risk assessment Predictive tests Research funding Receiver operating characteristic curves Academic medical centers T-test (Statistics) Data analysis Logistic regression analysis Blood collection Fisher exact test Descriptive statistics Severity of illness index Chi-squared test Surgical complications Longitudinal method Orthopedic surgery Blood plasma Delirium Statistics General anesthesia Confidence intervals Amyloid beta-protein precursor sug: subj: South Korea Pharmaceuticals and pharmacy supplies merchant wholesalers Risk assessment Predictive tests Research funding Receiver operating characteristic curves Academic medical centers T-test (Statistics) Data analysis Logistic regression analysis Blood collection Fisher exact test Descriptive statistics Severity of illness index Chi-squared test Surgical complications Longitudinal method Orthopedic surgery Blood plasma Delirium Statistics General anesthesia Confidence intervals Amyloid beta-protein precursor keyword: amyloid amyloid-β oligomers apolipoprotein e biological markers biomarkers blood tests copyrightHolder:British Geriatrics Society copyrightYear:2026 delirium diagnosis https://dx.doi.org/10.1093/ageing/afag106 inLanguage:en MDS-OAβ older adult older people oligomers operative orthopedics perioperative cardiovascular risk perioperative care plasma postoperative delirium preoperative care prevention publisher:Oxford University Press roc curve sameAs:https://pubmed.ncbi.nlm.nih.gov/42017417/ stratification surgical procedures amyloid amyloid-β oligomers apolipoprotein e biological markers biomarkers blood tests copyrightHolder:British Geriatrics Society copyrightYear:2026 delirium diagnosis https://dx.doi.org/10.1093/ageing/afag106 inLanguage:en MDS-OAβ older adult older people oligomers operative orthopedics perioperative cardiovascular risk perioperative care plasma postoperative delirium preoperative care prevention publisher:Oxford University Press roc curve sameAs:https://pubmed.ncbi.nlm.nih.gov/42017417/ stratification surgical procedures ab: Background Postoperative delirium is common in older surgical patients, but simple blood tests to identify risk are lacking. Plasma amyloid-β oligomers measured by multimer detection (MDS-OAβ) may reflect neurodegenerative vulnerability. Methods We enrolled 101 patients aged ≥65 years undergoing elective orthopaedic surgery with general anaesthesia. Blood was drawn preoperatively and at first delirium diagnosis or on postoperative Day 4 if no delirium. MDS-OAβ was quantified blinded. Delirium was assessed daily on postoperative Days 1–3 (DRS-R-98 and DSM). Propensity-score matching on APOE ε4 status and clinical covariates addressed Alzheimer-type vulnerability. Discrimination and thresholds (0.60, 0.72, 0.85 ng/ml) were evaluated using logistic regression and ROC analyses. Results Among 101 patients (44 with delirium; 57 without), preoperative MDS-OAβ concentrations were higher in those who developed delirium and correlated with delirium severity. In the overall cohort, preoperative MDS-OAβ discriminated delirium with an area under the curve of 0.855 (95% CI 0.777–0.919); in a pooled postoperative dataset (n = 205), discrimination was similar (AUC 0.884, 95% CI 0.837–0.925). The dual-threshold approach identified a low-risk group with high negative predictive value and a high-risk group with high positive predictive value, leaving an intermediate group for closer observation. Conclusions Preoperative plasma MDS-OAβ may provide a scalable biomarker for perioperative risk stratification of postoperative delirium in older adults, supporting a dual-threshold strategy for targeted prevention and monitoring. Low MDS-OAβ values indicate lower risk but do not exclude POD; biomarker-guided stratification should complement, not replace, routine perioperative delirium surveillance. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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