Perioperative total tau as a biomarker of postoperative delirium after major cardiac surgery: A prospective cohort study
Mohamed R. Mahmoud, Ali T. Abdelwahab, Tarek A. Abdelzaher, Mohamed M. Ali, Salman Hamdy Mohamed Elsaghir, Hassan Mokhtar Elshorbagy HettaABSTRACT
Background:
Postoperative delirium is a frequent and serious complication in older adults undergoing cardiac surgery with cardiopulmonary bypass (CPB). Identifying blood-based biomarkers of neuronal injury could facilitate early risk stratification. Total tau (t-tau), a microtubule-associated protein released during axonal damage, may serve as a candidate marker.
Methods:
In this prospective cohort study, 89 adults aged ≥60 years undergoing elective cardiac surgery with CPB were evaluated. Plasma t-tau levels were measured preoperatively and on postop D1 and D3. Cognitive and functional outcomes were assessed.
Results:
Delirium was diagnosed in 53% of patients on Postop D1 and 42% on postop D3. T-tau increased significantly from baseline (median 1.46 pg/mL) to postop D1 (3.13 pg/mL;
Conclusion:
Dynamic elevations in t-tau may predict postoperative delirium and neurocognitive decline after cardiac surgery with CPB. Therefore, t-tau may represent a promising candidate biomarker requiring external validation for risk stratification and monitoring of early postoperative delirium in older surgical patients.