Jung, M; Pan, X; Cunningham, EL; Passmore, AP; McGuinness, B; McAuley, DF; Beverland, D; ... Green, BD; + view all Jung, M; Pan, X; Cunningham, EL; Passmore, AP; McGuinness, B; McAuley, DF; Beverland, D; O’brien, S; Mawhinney, T; Schott, JM; Zetterberg, H; Green, BD; - view fewer (2022) The Influence of Orthopedic Surgery on Circulating Metabolite Levels, and their Associations with the Incidence of Postoperative Delirium. Metabolites , 12 (7) , Article 616. 10.3390/metabo12070616.

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Abstract

The mechanisms underlying the occurrence of postoperative delirium development are unclear and measurement of plasma metabolites may improve understanding of its causes. Participants (n = 54) matched for age and gender were sampled from an observational cohort study investigating postoperative delirium. Participants were ≥65 years without a diagnosis of dementia and presented for primary elective hip or knee arthroplasty. Plasma samples collected pre-and postoperatively were grouped as either control (n = 26, aged: 75.8 ± 5.2) or delirium (n = 28, aged: 76.2 ± 5.7). Widespread changes in plasma metabolite levels occurred following surgery. The only metabolites significantly differing between corresponding control and delirium samples were ornithine and spermine. In delirium cases, ornithine was 17.6% higher preoperatively, and spermine was 12.0% higher postoperatively. Changes were not associated with various perioperative factors. In binary logistic regression modeling, these two metabolites did not confer a significantly increased risk of delirium. These findings support the hypothesis that disturbed polyamine metabolism is an underlying factor in delirium that warrants further investigation.

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