Observational studyBMJ open2020
Cholinesterase alterations in delirium after cardiosurgery: a German monocentric prospective study.
Observational study in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Effects of neostigmine on postoperative neurocognitive dysfunction: a systematic review and meta-analysis.Frontiers in neuroscience · 2025Pooled it
- Electroencephalography Monitoring for Preventing Postoperative Delirium and Postoperative Cognitive Decline in Patients Undergoing Cardiothoracic Surgery: A Meta-Analysis.Reviews in cardiovascular medicine · 2024Pooled it
- Intraoperative oxygen concentration and postoperative delirium in elderly patients undergoing major abdominal surgery: a prospective randomized controlled clinical trial.International journal of colorectal disease · 2025Trial
- In a secondary analysis from a randomised, double-blind placebo-controlled trial Dexmedetomidine blocks cholinergic dysregulation in delirium pathogenesis in patients with major surgery.Scientific reports · 2023Trial
- Evolving Trends and Collaborative Networks in Postoperative Delirium Research: A Two-Decade Bibliometric Analysis.Brain and behavior · 2026Article
- The use of sugammadex and quantitative neuromuscular monitoring to facilitate fast-track liver transplantation: an observational study.BMC anesthesiology · 2026Observational
- Lower butyrylcholinesterase is associated with postoperative delirium in adult cardiac surgery patients: a secondary analysis of two prospective studies.BMC anesthesiology · 2026Article
- Mechanistic insights into postoperative delirium using untargeted high-throughput proteomics in elderly patients - a case-control study.Scientific reports · 2026Observational
- Preoperative butyrylcholinesterase activity and risk of postoperative delirium: A meta-analysis.World journal of psychiatry · 2026Article
- Recent advances in postoperative delirium in elderly patients: pathophysiological mechanisms, risk prediction, and therapeutic strategies.Frontiers in neuroscience · 2026Review
- Biomarkers of perioperative neurocognitive disorders after cardiac surgery: from mechanistic insights to clinical translation.Frontiers in neuroscience · 2026Review
- The Role of C-Reactive Protein as a Biomarker for Postoperative Delirium Following Cardiac and Neurosurgical Surgery: A Retrospective Analysis.Journal of clinical medicine · 2025Article
- Modification in ICU design may influence circadian serum cholinesterase activities: a proof-of-concept pilot study.Intensive care medicine experimental · 2024Article
- Postoperative delirium: A tragedy for elderly cancer patients.World journal of gastrointestinal oncology · 2024Article
- Article
- Optimization of the cardiac delirium index by including age, decrease in butyrylcholinesterase actitivity, preoperative HbA1c, and postoperative hemoglobin levels: results of a secondary analysis of a prospective observational study.Frontiers in cardiovascular medicine · 2024Article
- Potentials of Acetylcholinesterase and Butyrylcholinesterase Alterations in On-Pump Coronary Artery Bypass Surgery in Postoperative Delirium: An Observational Trial.Journal of clinical medicine · 2023Article
- Preclinical and translational models for delirium: Recommendations for future research from the NIDUS delirium network.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2023Review
- Meta-analysis of serological biomarkers at hospital admission for the likelihood of developing delirium during hospitalization.Frontiers in neurology · 2023Article
- Biomarkers of delirium risk in older adults: a systematic review and meta-analysis.Frontiers in aging neuroscience · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesPostoperative delirium (POD) is a common complication after elective cardiac surgery. Recent evidence indicates that a disruption in the normal activity of the cholinergic system may be associated with delirium.
designProspective observational study.
settingSingle-centre at a European academic hospital. PRIMARY AND SECONDARY OUTCOME MEASURES: In our study the enzyme activities of acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) were determined preoperatively as well as on the first and second postoperative day. The confusion assessment method for the intensive care unit was used to screen patients for the presence of POD.
resultsA total of 114 patients were included in the study. POD was associated with a decrease in BChE activity on postoperative day 1 (p=0.03). In addition, patients who developed POD, had significantly lower preoperative AChE activity than patients without POD (p<0.01). Multivariate analysis identified a preoperatively decreased AChE activity (OR 3.1; 95% CI 1.14 to 8.46), anticholinergic treatment (OR 5.09; 95% CI 1.51 to 17.23), elevated European System for Cardiac Operative Risk Evaluation (OR 3.68; 95% CI 1.04 to 12.99) and age (OR 3.02; 95% CI 1.06 to 8.62) to be independently associated with the development of POD.
conclusionsWe conclude that a reduction in the acetylcholine hydrolysing enzyme activity in patients undergoing cardiac surgery may correlate with the development of POD.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.