Biomarker analysis of prediction of delirium after laparoscopic surgery in gynecologic oncology / 中国内镜杂志

ABSTRACT

Objective To investigate the prognostic value of serum neutrophil gelatinase associated protein lipocalin (NGAL) and S-100β protein level on postoperative delirium (POD) in patient underwent gynecological laparoscopic tumor resection. Methods 256 patients underwent gynecological laparoscopic tumor resection from March 2015 to June 2016 were enrolled the study and divided into POD group (n = 31) and non-POD group (n = 225). Serum levels of NGAL, S-100β protein, creatinine (Scr) and cystatin C (Cys-c) were compared between the two groups at 5 min before anesthesia induction, immediately after extubation, during their stay in post anesthesia care unit (PACU) and at 24, 48, 72 h after operation. The area under receiver-operating characteristic curve (AUC) was performed to evaluate prognostic value of each index in POD. Results Serum levels of NGAL and S-100βafter anesthesia in the two groups were all significantly higher than those before anesthesia (P < 0.05). Serum levels of NGAL in POD group immediately after extubation, during their stay in PACU and at 24 h after operation were significantly higher than those in non-POD group (P < 0.05). Serum levels of S-100β protein in POD group immediately after extubation, durng their stay in PACU and at 24, 48, 72 h after operation were significantly higherthan those in non-POD group (P < 0.05). There was no acute renal injury in all patients. There were no significant difference in serum levels of Scr and Cys-C between two groups at every time points (P > 0.05). The AUC of serum NGAL and S-100 protein immediately after extubation, durng their stay in PACU and at 24h after operation were 0.75, 0.77, 0.66 and 0.85, 0.83, 0.80 respectively (P < 0.05). Conclusions Serum NGAL and S-100β protein levels could be used as predictors of POD in patients undergoing gynecological laparoscopic tumor resection, and prediction effect of the latter was better, especially immediately after extubation and durng their stay in PACU.