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Postoperative cognitive disorders, including postoperative cognitive dysfunction (POCD) and postoperative delirium (POD), are common complications following surgery and anesthesia, particularly in vulnerable patient populations. These conditions are associated with increased morbidity, prolonged hospitalization, and higher healthcare costs. Early identification of patients at risk remains challenging, and reliable biomarkers are needed to improve perioperative risk stratification.
S100B protein has been proposed as a biomarker of neuronal injury and blood-brain barrier dysfunction. In addition, genetic variations in the S100B gene may influence individual susceptibility to postoperative cognitive impairment.
The aim of this prospective cohort study is to evaluate the association between perioperative serum S100B levels, S100B gene polymorphisms, and postoperative cognitive disorders. Furthermore, the predictive value of perioperative changes in S100B levels for postoperative cognitive dysfunction and delirium will be investigated.
Postoperative cognitive disorders, including postoperative cognitive dysfunction (POCD) and postoperative delirium (POD), are common complications associated with surgery and anesthesia. These conditions affect perception, memory, and learning abilities, and are associated with increased morbidity, prolonged hospital and intensive care unit stays, and higher healthcare costs. Although the exact mechanisms underlying these disorders are not fully understood, perioperative inflammatory processes and neuronal injury are considered key contributing factors.
In recent years, considerable research has focused on identifying reliable biomarkers for the early prediction of postoperative cognitive disorders. Among these, S100B protein has emerged as a promising marker of neuronal injury and blood-brain barrier dysfunction. In addition, single nucleotide polymorphisms (SNPs) in the S100B gene may influence individual susceptibility to cognitive impairment.
The aim of this study is to investigate the relationship between serum S100B levels, S100B gene polymorphisms, and postoperative cognitive disorders.
In this prospective study, preoperative cognitive function will be assessed using standardized cognitive tests. Blood samples will be collected preoperatively and within 30 minutes after surgery for the measurement of serum S100B levels. Cognitive assessment will be performed preoperatively and repeated at 1, 3, and 6 months after surgery. Patients will also be evaluated for postoperative delirium during the first 3 postoperative days.
The incidence of postoperative cognitive dysfunction and postoperative delirium will be recorded, and the association between S100B levels, genetic polymorphisms, and cognitive outcomes will be analyzed. The predictive value of these biomarkers for postoperative cognitive disorders will also be evaluated. Particular emphasis will be placed on the perioperative change in S100B levels (ΔS100B) as a potential predictor of postoperative cognitive outcomes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Surgical Patients | Patients undergoing surgery who were prospectively followed for postoperative delirium and postoperative cognitive dysfunction with serial cognitive assessments, serum S100B measurements, and S100B gene polymorphism analyses. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Perioperative Assessment | Other | Observational study with no assigned intervention. Patients were evaluated with perioperative blood sampling for S100B levels and genetic analysis, and were followed for postoperative cognitive outcomes. |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative Cognitive Dysfunction | Postoperative cognitive dysfunction assessed using the Montreal Cognitive Assessment (MoCA). Cognitive assessment was performed preoperatively and repeated at 1, 3, and 6 months after surgery. | 6 months after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative Delirium | Incidence of postoperative delirium assessed during the first 3 postoperative days. | Within the first 3 postoperative days |
| Perioperative Serum S100B Levels | Serum S100B protein levels measured in blood samples collected preoperatively and within 30 minutes after surgery. |
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Inclusion Criteria:
Exclusion Criteria:
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The study population consists of adult patients undergoing elective surgery under anesthesia who were prospectively enrolled. Patients were evaluated for postoperative cognitive dysfunction and postoperative delirium using standardized cognitive assessments. Perioperative blood samples were collected for the measurement of serum S100B levels and for the analysis of S100B gene polymorphisms. All participants were followed for cognitive outcomes up to 6 months after surgery.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ankara University Faculty of Medicine | Ankara | Ankara | 06000 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30325806 | Background | Evered L, Silbert B, Knopman DS, Scott DA, DeKosky ST, Rasmussen LS, Oh ES, Crosby G, Berger M, Eckenhoff RG; Nomenclature Consensus Working Group. Recommendations for the Nomenclature of Cognitive Change Associated with Anaesthesia and Surgery-2018. Anesthesiology. 2018 Nov;129(5):872-879. doi: 10.1097/ALN.0000000000002334. | |
| 15817019 |
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Individual participant data will not be shared.
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Blood samples were collected preoperatively and within 30 minutes after surgery. Serum samples were used for the measurement of S100B protein levels. In addition, DNA was extracted from blood samples for the analysis of single nucleotide polymorphisms (SNPs) in the S100B gene. Biospecimens were stored for further analysis.
| Preoperatively and within 30 minutes after surgery |
| S100B Gene Polymorphisms | Single nucleotide polymorphisms in the S100B gene analyzed from preoperative blood samples. | Preoperative period |
| Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, Cummings JL, Chertkow H. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005 Apr;53(4):695-9. doi: 10.1111/j.1532-5415.2005.53221.x. |
| 30797230 | Background | Ayob F, Lam E, Ho G, Chung F, El-Beheiry H, Wong J. Pre-operative biomarkers and imaging tests as predictors of post-operative delirium in non-cardiac surgical patients: a systematic review. BMC Anesthesiol. 2019 Feb 23;19(1):25. doi: 10.1186/s12871-019-0693-y. |
| ID | Term |
|---|---|
| D000079690 | Postoperative Cognitive Complications |
| D000071257 | Emergence Delirium |
| D060825 | Cognitive Dysfunction |
| D000090862 | Neuroinflammatory Diseases |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D003072 | Cognition Disorders |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| D003693 | Delirium |
| D003221 | Confusion |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D007249 | Inflammation |
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