Serum proteomic analysis in esophagectomy patients with postoperative delirium: A Case-Control Study

dc.contributor.authorKhan, Sikandar H.
dc.contributor.authorPerkins, Anthony J.
dc.contributor.authorJawaid, Samreen
dc.contributor.authorWang, Sophia
dc.contributor.authorLindroth, Heidi
dc.contributor.authorSchmitt, Rebecca E.
dc.contributor.authorDoles, Jason
dc.contributor.authorTrue, Jason D.
dc.contributor.authorGao, Sujuan
dc.contributor.authorCaplan, Gideon A.
dc.contributor.authorTwigg, Homer L., III
dc.contributor.authorKesler, Kenneth
dc.contributor.authorKhan, Babar A.
dc.contributor.departmentMedicine, School of Medicine
dc.date.accessioned2025-02-25T12:15:00Z
dc.date.available2025-02-25T12:15:00Z
dc.date.issued2024
dc.description.abstractBackground: Postoperative delirium occurs in up to 80% of patients undergoing esophagectomy. We performed an exploratory proteomic analysis to identify protein pathways that may be associated with delirium post-esophagectomy. Objectives: Identify proteins associated with delirium and delirium severity in a younger and higher-risk surgical population. Methods: We performed a case-control study using blood samples collected from patients enrolled in a negative, randomized, double-blind clinical trial. English speaking adults aged 18 years or older, undergoing esophagectomy, who had blood samples obtained were included. Cases were defined by a positive delirium screen after surgery while controls were patients with negative delirium assessments. Delirium was assessed using Richmond Agitation Sedation Scale and Confusion Assessment Method for the Intensive Care Unit, and delirium severity was assessed by Delirium Rating Scale-Revised-98. Blood samples were collected pre-operatively and on post-operative day 1, and discovery proteomic analysis was performed. Between-group differences in median abundance ratios were reported using Wilcoxon-Mann-Whitney Odds (WMWodds1) test. Results: 52 (26 cases, 26 controls) patients were included in the study with a mean age of 64 (SD 9.6) years, 1.9% were females and 25% were African American. The median duration of delirium was 1 day (IQR: 1-2), and the median delirium/coma duration was 2.5 days (IQR: 2-4). Two proteins with greater relative abundance ratio in patients with delirium were: Coagulation factor IX (WMWodds: 1.89 95%CI: 1.0-4.2) and mannosyl-oligosaccharide 1,2-alpha-mannosidase (WMWodds: 2.4 95%CI: 1.03-9.9). Protein abundance ratios associated with mean delirium severity at postoperative day 1 were Complement C2 (Spearman rs = -0.31, 95%CI [-0.55, -0.02]) and Mannosyl-oligosaccharide 1,2-alpha-mannosidase (rs = 0.61, 95%CI = [0.29, 0.81]). Conclusions: We identified changes in proteins associated with coagulation, inflammation, and protein handling; larger, follow-up studies are needed to confirm our hypothesis-generating findings.
dc.eprint.versionAuthor's manuscript
dc.identifier.citationKhan SH, Perkins AJ, Jawaid S, et al. Serum proteomic analysis in esophagectomy patients with postoperative delirium: A case-control study. Heart Lung. 2024;63:35-41. doi:10.1016/j.hrtlng.2023.09.009
dc.identifier.urihttps://hdl.handle.net/1805/46008
dc.language.isoen_US
dc.publisherElsevier
dc.relation.isversionof10.1016/j.hrtlng.2023.09.009
dc.relation.journalHeart & Lung
dc.rightsPublisher Policy
dc.sourcePMC
dc.subjectComa
dc.subjectCritical care
dc.subjectDelirium severity
dc.subjectEncephalopathy
dc.subjectProteins
dc.titleSerum proteomic analysis in esophagectomy patients with postoperative delirium: A Case-Control Study
dc.typeArticle
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