Serum proteomic analysis in esophagectomy patients with postoperative delirium: A case-control study.
Sikandar H Khan, Anthony J Perkins, Samreen Jawaid and 10 others
PMID 37748302WHAT IT FOUND
Six serum proteins differed between esophagectomy patients with and without postoperative delirium.
Two proteins were higher in patients with delirium. These are exploratory biomarker candidates, not validated tests or evidence that they cause delirium.
Key findings
01Six serum proteins had different abundance ratios between esophagectomy patients with and without postoperative delirium.
02Coagulation factor IX and mannosyl-oligosaccharide 1,2-alpha-mannosidase had higher abundance ratios in patients with delirium.
03Among patients with delirium, MAN1A1 abundance ratio correlated with mean DRS-R-98 severity (r_s = 0.71), while Complement C2 abundance ratio correlated negatively (r_s = -0.32).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Small, exploratory case-control study with 26 patients with delirium and 26 without. No sample size was pre-determined, and results were not adjusted for multiple comparisons or false discovery rates. No validation cohort or protein-specific confirmatory testing was performed. Only pre-operative and post-operative day 1 samples were compared, so later protein changes may have been missed. Protein associations may have been confounded by inflammation from esophageal malignancy. Patients were enrolled in a trial of haloperidol versus placebo, so a small effect of haloperidol on protein results cannot be excluded.
Declared interests
The authors declared no competing interests.
The easy way to misread this
Do not read the protein differences as a validated bedside test or as proof that these proteins cause delirium. The study was exploratory, had no validation cohort, and was not corrected for multiple comparisons.