Alcohol consumption may be associated with postoperative delirium in the elderly: the PNDABLE study

BMC Anesthesiology

Research

Bin Zhou¹  Ning Zhang²  Yanlin Bi²  Bin Wang²  Xinhui Tang²  Jiahan Wang²  Siyu Liu²  Xu Lin²  Xiaoyue Wu²  Fei Wang² 

[1] Department of Anesthesiology, Qingdao Eighth People’s Hospital, Qingdao, China;Department of Anesthesiology, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), 5, Dong-Hai Middle Road, Shi-Nan District, 266000, Qingdao, China;

关键词: Elderly;    Alcohol consumption;    Alzheimer-related biomarkers;    Cerebrospinal fluid;   

DOI  :  10.1186/s12871-023-02178-x

 received in 2023-01-16, accepted in 2023-06-13,  发布年份 2023

来源: Springer

【 摘 要 】

ObjectivesThis study aimed to reveal the relationship between alcohol consumption and Postoperative delirium (POD) in the elderly.MethodsWe selected 252 patients from the Perioperative Neurocognitive Disorder And Biomarker Lifestyle (PNDABLE ) study. Patients in the PNDABLE database have been measured for Alzheimer-related biomarkers in CSF (Aβ40, Aβ42, P-tau, and tau protein). Mini-Mental State Examination (MMSE) was used to assess the preoperative mental status of patients. POD was diagnosed using the Confusion Assessment Method (CAM) and assessed for severity using the Memorial Delirium Assessment Scale (MDAS). Logistic regression analysis was utilized to explore the association of alcohol consumption with POD. Linear regression analysis was used to study the relationship between alcohol consumption and CSF biomarkers. Mediation analyses with 10,000 bootstrapped iterations were used to explore the mediation effects. Finally, we constructed the receiver operating characteristic (ROC) curve and the nomogram model to evaluate the efficacy of alcohol consumption and CSF biomarkers in predicting POD. ResultThe incidence of POD was 17.5%. Logistic regression showed that alcohol consumption (OR = 1.016, 95%CI 1.009–1.024, P < 0.001) is a risk factor for POD. What’s more, Aβ42 is a protective factor for POD (OR = 0.993, 95%CI 0.989–0.997, P < 0.05), and P-Tau was a risk factor for POD (OR = 1.093, 95%CI 1.022–1.168, P < 0.05). Linear regression analysis revealed that alcohol consumption was negatively associated with CSF Aβ42 (β = -0.638, P < 0.001) in POD patients. Mediation analyses showed that alcohol consumption is likely to partially mediate POD through Aβ42 (proportion:14.21%). ROC curve showed that alcohol consumption (AUC = 0.904; P < 0.001) exhibited a relatively better discriminatory ability in POD prediction compared to Aβ42 (AUC = 0.798; P < 0.001). The calibration curve indicated a good nomogram prediction (P = 0.797).ConclusionAlcohol consumption is a risk factor for POD (particularly for those with > 24 g a day on average) in the elderly, and contributes to POD through the mediation of Aβ42.

【 授权许可】

CC BY   
© The Author(s) 2023

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