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Differences in potential biomarkers of delirium between acutely ill medical and elective cardiac surgery patients. / Egberts, Angelique; Osse, Robert J.; Fekkes, Durk; Tulen, Joke H.M.; van der Cammen, Tischa J.M.; Mattace-Raso, Francesco U.S.

In: CLINICAL INTERVENTIONS IN AGING, Vol. 14, 2019, p. 271-281.

Research output: Contribution to journalArticleScientificpeer-review

Harvard

Egberts, A, Osse, RJ, Fekkes, D, Tulen, JHM, van der Cammen, TJM & Mattace-Raso, FUS 2019, 'Differences in potential biomarkers of delirium between acutely ill medical and elective cardiac surgery patients', CLINICAL INTERVENTIONS IN AGING, vol. 14, pp. 271-281. https://doi.org/10.2147/CIA.S193605

APA

Egberts, A., Osse, R. J., Fekkes, D., Tulen, J. H. M., van der Cammen, T. J. M., & Mattace-Raso, F. U. S. (2019). Differences in potential biomarkers of delirium between acutely ill medical and elective cardiac surgery patients. CLINICAL INTERVENTIONS IN AGING, 14, 271-281. https://doi.org/10.2147/CIA.S193605

Vancouver

Author

Egberts, Angelique ; Osse, Robert J. ; Fekkes, Durk ; Tulen, Joke H.M. ; van der Cammen, Tischa J.M. ; Mattace-Raso, Francesco U.S. / Differences in potential biomarkers of delirium between acutely ill medical and elective cardiac surgery patients. In: CLINICAL INTERVENTIONS IN AGING. 2019 ; Vol. 14. pp. 271-281.

BibTeX

@article{1c4b07ecd9c447959c3891920ae5cf25,
title = "Differences in potential biomarkers of delirium between acutely ill medical and elective cardiac surgery patients",
abstract = "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",
author = "Angelique Egberts and Osse, {Robert J.} and Durk Fekkes and Tulen, {Joke H.M.} and {van der Cammen}, {Tischa J.M.} and Mattace-Raso, {Francesco U.S.}",
year = "2019",
doi = "10.2147/CIA.S193605",
language = "English",
volume = "14",
pages = "271--281",
journal = "CLINICAL INTERVENTIONS IN AGING",
issn = "1178-1998",
publisher = "Dove Medical Press Ltd.",

}

RIS

TY - JOUR

T1 - Differences in potential biomarkers of delirium between acutely ill medical and elective cardiac surgery patients

AU - Egberts, Angelique

AU - Osse, Robert J.

AU - Fekkes, Durk

AU - Tulen, Joke H.M.

AU - van der Cammen, Tischa J.M.

AU - Mattace-Raso, Francesco U.S.

PY - 2019

Y1 - 2019

N2 - 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.

AB - 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.

KW - Delirium

KW - Inflammation

KW - Neopterin

KW - Oxidative stress

KW - Renal function

UR - http://www.scopus.com/inward/record.url?scp=85062087194&partnerID=8YFLogxK

U2 - 10.2147/CIA.S193605

DO - 10.2147/CIA.S193605

M3 - Article

C2 - 30799917

AN - SCOPUS:85062087194

VL - 14

SP - 271

EP - 281

JO - CLINICAL INTERVENTIONS IN AGING

JF - CLINICAL INTERVENTIONS IN AGING

SN - 1178-1998

ER -

ID: 56147812