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Title: Predicting the risk of post-operative delirium : use of neuropsychology, serum and CSF biomarkers and genetics to predict risk of post-operative delirium
Author: Cunningham, Emma Louise
ISNI:       0000 0004 5995 0035
Awarding Body: Queen's University Belfast
Current Institution: Queen's University Belfast
Date of Award: 2015
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Delirium following surgery is common and is associated with negative outcomes. Across surgical populations pre-operative cognitive impairment is a consistent risk factor for post-operative delirium. This study tests the hypothesis that the quantification of brain vulnerability, using neuropsychological tests, plasma and cerebrospinal fluid (CSF) biomarkers, and Apolipoprotein E status, can quantify the risk of post-operative delirium following elective primary arthroplasty surgery. An observational cohort study of patients over 65 years of age, admitted for elective primary hip or knee arthroplasty, under spinal anaesthetic, was undertaken with participants recruited between 23rd March 2012 and 21st October 2014. Of the 315 participants completing the study 40 (12.7%) developed delirium post-operatively. On univariate analyses several baseline characteristics, pre-operative performance on several neurocognitive tests, pre-operative plasma albumin concentration and CSF matrix metalloproteinase (MMP) 3 concentration were associated with post-oper:ative delirium. Only one pre-operative neuropsychological test - 3-item recall - and CSF MMP-3 concentration remained significant following multivariate analyses involving the entire cohort. The findings of this study support the hypothesis that quantification of brain vulnerability can predict the risk of delirium following elective arthroplasty surgery.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available