Relationship between postoperative biomarkers of neuronal injury and postoperative cognitive dysfunction: A meta-analysis

Xiaohua Wang; Xinli Chen; Fan Wu; Yingchao Liu; Yushen Yang; Weican Chen; Zhigang Pan; Weipeng Hu; Feng Zheng; Hefan He

doi:10.1371/journal.pone.0284728

Relationship between postoperative biomarkers of neuronal injury and postoperative cognitive dysfunction: A meta-analysis

PLoS One. 2023 Apr 25;18(4):e0284728. doi: 10.1371/journal.pone.0284728. eCollection 2023.

Authors

Xiaohua Wang¹, Xinli Chen¹, Fan Wu¹, Yingchao Liu¹, Yushen Yang¹, Weican Chen¹, Zhigang Pan², Weipeng Hu², Feng Zheng², Hefan He¹

Affiliations

¹ Department of Anesthesiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, China.
² Department of Neurosurgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, China.

Abstract

Early biomarkers are needed to identify patients at risk of developing postoperative cognitive dysfunction (POCD). Our objective was to determine neuronal injury-related biomarkers with predictive values for this condition. Six biomarkers (S100β, neuron-specific enolase [NSE], amyloid beta [Aβ], tau, neurofilament light chain, and glial fibrillary acidic protein) were evaluated. According to the first postoperative sampling time, observational studies showed that S100β was significantly higher in patients with POCD than in those without POCD (standardized mean difference [SMD]: 6.92, 95% confidence interval [CI]: 4.44-9.41). The randomized controlled trial (RCT) showed that S100β (SMD: 37.31, 95% CI: 30.97-43.64) and NSE (SMD: 3.50, 95% CI: 2.71-4.28) in the POCD group were significantly higher than in the non-POCD group. The pooled data of observational studies by postoperative sampling time showed significantly higher levels of the following biomarkers in the POCD groups than in the control groups: S100β levels at 1 hour (SMD: 1.35, 95% CI: 0.07-2.64), 2 days (SMD: 27.97, 95% CI: 25.01-30.94), and 9 days (SMD: 6.41, 95% CI: 5.64-7.19); NSE levels at 1 hour (SMD: 0.92, 95% CI: 0.25-1.60), 6 hours (SMD: 0.79, 95% CI: 0.12-1.45), and 24 hours (SMD: 0.84, 95% CI: 0.38-1.29); and Aβ levels at 24 hours (SMD: 2.30, 95% CI: 1.54-3.06), 2 days (SMD: 2.30, 95% CI: 1.83-2.78), and 9 days (SMD: 2.76, 95% CI: 2.25-3.26). The pooled data of the RCT showed that the following biomarkers were significantly higher in POCD patients than in non-POCD patients: S100β levels at 2 days (SMD: 37.31, 95% CI: 30.97-43.64) and 9 days (SMD: 126.37, 95% CI: 104.97-147.76) and NSE levels at 2 days (SMD: 3.50, 95% CI: 2.71-4.28) and 9 days (SMD: 8.53, 95% CI: 7.00-10.06). High postoperative levels of S100β, NSE, and Aβ may predict POCD. The relationship between these biomarkers and POCD may be affected by sampling time.

Copyright: © 2023 Wang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't

MeSH terms

Biomarkers / metabolism
Cognitive Dysfunction* / diagnosis
Cognitive Dysfunction* / etiology
Humans
Postoperative Cognitive Complications*
Postoperative Complications / diagnosis
Postoperative Complications / etiology
Postoperative Complications / metabolism
S100 Calcium Binding Protein beta Subunit

Substances

Biomarkers
S100 Calcium Binding Protein beta Subunit

Grants and funding

This work was supported by grants from the Natural Science Foundation of Fujian Province (2020J01227), the Medical Innovation Science and Technology Project of Fujian Province (2020CXA047), and the Doctoral Startup Fund of the Second Affiliated Hospital of Fujian Medical University (BS202205).Funders have no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.