Differences in potential biomarkers of delirium between acutely ill medical and elective cardiac surgery patients

Angelique Egberts,1 Robert J Osse,2 Durk Fekkes,2,3 Joke HM Tulen,2 Tischa JM van der Cammen,1 Francesco US Mattace-Raso1 1Section of Geriatric Medicine, Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands; 2Department of Psychiatry, Erasmus MC Universi...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Egberts A, Osse RJ, Fekkes D, Tulen JHM, van der Cammen TJM, Mattace-Raso FUS
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	delirium inflammation neopterin oxidative stress renal function Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/4855ac53b06f4cb8a3af077c87534f7f
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:4855ac53b06f4cb8a3af077c87534f7f
record_format	dspace
spelling	oai:doaj.org-article:4855ac53b06f4cb8a3af077c87534f7f2021-12-02T05:07:07ZDifferences in potential biomarkers of delirium between acutely ill medical and elective cardiac surgery patients1178-1998https://doaj.org/article/4855ac53b06f4cb8a3af077c87534f7f2019-02-01T00:00:00Zhttps://www.dovepress.com/differences-in-potential-biomarkers-of-delirium-between-acutely-ill-me-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Angelique Egberts,1 Robert J Osse,2 Durk Fekkes,2,3 Joke HM Tulen,2 Tischa JM van der Cammen,1 Francesco US Mattace-Raso1 1Section of Geriatric Medicine, Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands; 2Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, the Netherlands; 3Department of Clinical Chemistry, Erasmus MC University Medical Center, Rotterdam, the Netherlands Background/aims: The pathophysiology of delirium is poorly understood. Increasing evidence suggests that different pathways might be involved in the pathophysiology depending on the population studied. The aim of the present study was to investigate potential differences in mean plasma levels of neopterin, amino acids, amino acid ratios and homovanillic acid between two groups of patients with delirium.Methods: Data from acutely ill medical patients aged 65 years and older, and patients aged 70 years and older undergoing elective cardiac surgery, were used. Differences in biomarker levels between the groups were investigated using univariate ANOVA with adjustments for age, sex, comorbidities, C-reactive protein (CRP) and the estimated glomerular filtration rate (eGFR), where appropriate. Linear regression analysis was used to identify potential determinants of the investigated biochemical markers.Results: Eighty patients with delirium were included (23 acutely ill medical patients and 57 elective cardiac surgery patients). After adjustment, higher mean neopterin levels (93.1 vs 47.3 nmol/L, P=0.001) and higher phenylalanine/tyrosine ratios (1.39 vs 1.15, P=0.032) were found in acutely ill medical patients when compared to elective cardiac surgery patients. CRP levels were positively correlated with neopterin levels in acutely ill medical patients, explaining 28.4% of the variance in neopterin levels. eGFR was negatively correlated with neopterin in elective cardiac surgery patients, explaining 53.7% of the variance in neopterin levels.Conclusion: In this study, we found differences in mean neopterin levels and phenylalanine/tyrosine ratios between acutely ill medical and elective cardiac surgery patients with delirium. Moreover, our findings may suggest that in acutely ill medical patients, neopterin levels are mainly determined by inflammation/oxidative stress whereas in elective cardiac surgery patients, neopterin levels are mainly driven by renal function/fluid status. These findings suggest that the markers and pathways that might be involved in the pathophysiology of delirium may differ between specific groups of patients. Keywords: delirium, inflammation, neopterin, oxidative stress, renal functionEgberts AOsse RJFekkes DTulen JHMvan der Cammen TJMMattace-Raso FUSDove Medical Pressarticledeliriuminflammationneopterinoxidative stressrenal functionGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 14, Pp 271-281 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	delirium inflammation neopterin oxidative stress renal function Geriatrics RC952-954.6
spellingShingle	delirium inflammation neopterin oxidative stress renal function Geriatrics RC952-954.6 Egberts A Osse RJ Fekkes D Tulen JHM van der Cammen TJM Mattace-Raso FUS Differences in potential biomarkers of delirium between acutely ill medical and elective cardiac surgery patients
description	Angelique Egberts,1 Robert J Osse,2 Durk Fekkes,2,3 Joke HM Tulen,2 Tischa JM van der Cammen,1 Francesco US Mattace-Raso1 1Section of Geriatric Medicine, Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands; 2Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, the Netherlands; 3Department of Clinical Chemistry, Erasmus MC University Medical Center, Rotterdam, the Netherlands Background/aims: The pathophysiology of delirium is poorly understood. Increasing evidence suggests that different pathways might be involved in the pathophysiology depending on the population studied. The aim of the present study was to investigate potential differences in mean plasma levels of neopterin, amino acids, amino acid ratios and homovanillic acid between two groups of patients with delirium.Methods: Data from acutely ill medical patients aged 65 years and older, and patients aged 70 years and older undergoing elective cardiac surgery, were used. Differences in biomarker levels between the groups were investigated using univariate ANOVA with adjustments for age, sex, comorbidities, C-reactive protein (CRP) and the estimated glomerular filtration rate (eGFR), where appropriate. Linear regression analysis was used to identify potential determinants of the investigated biochemical markers.Results: Eighty patients with delirium were included (23 acutely ill medical patients and 57 elective cardiac surgery patients). After adjustment, higher mean neopterin levels (93.1 vs 47.3 nmol/L, P=0.001) and higher phenylalanine/tyrosine ratios (1.39 vs 1.15, P=0.032) were found in acutely ill medical patients when compared to elective cardiac surgery patients. CRP levels were positively correlated with neopterin levels in acutely ill medical patients, explaining 28.4% of the variance in neopterin levels. eGFR was negatively correlated with neopterin in elective cardiac surgery patients, explaining 53.7% of the variance in neopterin levels.Conclusion: In this study, we found differences in mean neopterin levels and phenylalanine/tyrosine ratios between acutely ill medical and elective cardiac surgery patients with delirium. Moreover, our findings may suggest that in acutely ill medical patients, neopterin levels are mainly determined by inflammation/oxidative stress whereas in elective cardiac surgery patients, neopterin levels are mainly driven by renal function/fluid status. These findings suggest that the markers and pathways that might be involved in the pathophysiology of delirium may differ between specific groups of patients. Keywords: delirium, inflammation, neopterin, oxidative stress, renal function
format	article
author	Egberts A Osse RJ Fekkes D Tulen JHM van der Cammen TJM Mattace-Raso FUS
author_facet	Egberts A Osse RJ Fekkes D Tulen JHM van der Cammen TJM Mattace-Raso FUS
author_sort	Egberts A
title	Differences in potential biomarkers of delirium between acutely ill medical and elective cardiac surgery patients
title_short	Differences in potential biomarkers of delirium between acutely ill medical and elective cardiac surgery patients
title_full	Differences in potential biomarkers of delirium between acutely ill medical and elective cardiac surgery patients
title_fullStr	Differences in potential biomarkers of delirium between acutely ill medical and elective cardiac surgery patients
title_full_unstemmed	Differences in potential biomarkers of delirium between acutely ill medical and elective cardiac surgery patients
title_sort	differences in potential biomarkers of delirium between acutely ill medical and elective cardiac surgery patients
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/4855ac53b06f4cb8a3af077c87534f7f
work_keys_str_mv	AT egbertsa differencesinpotentialbiomarkersofdeliriumbetweenacutelyillmedicalandelectivecardiacsurgerypatients AT osserj differencesinpotentialbiomarkersofdeliriumbetweenacutelyillmedicalandelectivecardiacsurgerypatients AT fekkesd differencesinpotentialbiomarkersofdeliriumbetweenacutelyillmedicalandelectivecardiacsurgerypatients AT tulenjhm differencesinpotentialbiomarkersofdeliriumbetweenacutelyillmedicalandelectivecardiacsurgerypatients AT vandercammentjm differencesinpotentialbiomarkersofdeliriumbetweenacutelyillmedicalandelectivecardiacsurgerypatients AT mattacerasofus differencesinpotentialbiomarkersofdeliriumbetweenacutelyillmedicalandelectivecardiacsurgerypatients
_version_	1718400587148558336

Differences in potential biomarkers of delirium between acutely ill medical and elective cardiac surgery patients

Ejemplares similares