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Interleukin 8 in postoperative delirium - preliminary findings from two studies

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Item Type:Article
Title:Interleukin 8 in postoperative delirium - preliminary findings from two studies
Creators Name:Lammers-Lietz, F. and Akyuz, L. and Feinkohl, I. and Lachmann, C. and Pischon, T. and Volk, H.D. and von Häfen, C. and Yürek, F. and Winterer, G. and Spies, C.D.
Abstract:OBJECTIVE: Studies have suggested that inflammation contributes to the pathogenesis of postoperative delirium, but previous results on the proinflammatory cytokine IL-8 in plasma are contradictory. Additionally, a significant fraction of IL-8 is bound to erythrocytes, but the relevance of whole blood IL-8 in delirium has not been studied. In this work, we analyzed the association of postoperative delirium with levels of unbound IL-8 in plasma and levels of IL-8 in whole blood in patients from two studies which were conducted in our department and have not been presented previously. We assessed the prognostic value of whole blood IL-8. METHODS: Plasma/whole blood IL-8 was measured at least once in N ​= ​504 patients preoperatively, on day one (d1) and/or three months after surgery in the BioCog observational study. Whole blood IL-8 was measured in N ​= ​64 patients from the PHYDELIO trial preoperatively, on d1 and d7 after surgery. For the determination of whole blood IL-8, EDTA-preserved blood samples underwent lysis by adding Triton-X100 surfactant. Plasma and whole blood IL-8 levels were assessed with two different immunoassay kits. Delirium was appraised systematically for seven postoperative days according to DSM criteria using two comparable protocols consisting of validated screening tools. RESULTS: Delirium occurred in 25% of BioCog and 14% of PHYDELIO patients. In BioCog, IL-8 was elevated on d1 and in delirious patients. A steeper postoperative increase in delirium was confounded by surgery-related factors. A crescendo-decrescendo pattern of whole blood IL-8 levels was observed in non-delirious patients with a peak on d1. This pattern was more distinct in delirious BioCog patients, but inverted in delirious PHYDELIO patients. Preoperative whole blood IL-8>318.4 ​pg/mL (reference <150 ​pg/mL) had adequate sensitivity (0.79/0.78) and specificity (0.53/0.67) for delirium in both samples. CONCLUSION: Our results contribute to an inflammatory hypothesis of postoperative delirium.
Source:Brain Behavior & Immunity - Health
Page Range:100419
Date:March 2022
Official Publication:https://doi.org/10.1016/j.bbih.2022.100419
PubMed:View item in PubMed

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