Observational studyPloS one2021
Elevated neuron-specific enolase level is associated with postoperative delirium and detection of phosphorylated neurofilament heavy subunit: A prospective observational study.
Observational study in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 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
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 23 citations in OpenAlex.
- Diagnostic utility of neurogenic biomarkers in differentiating sepsis with and without associated encephalopathy: a systematic review and meta-analytic approach.Frontiers in neurology · 2025Pooled it
- Neuron-specific enolase at admission as a predictor for stroke volume, severity and outcome in ischemic stroke patients: a prognostic biomarker review.Scientific reports · 2024Pooled it
- Trial
- Effect of optimizing cerebral oxygen saturation on postoperative delirium in older patients undergoing one-lung ventilation for thoracoscopic surgery.The Journal of international medical research · 2024Trial
- J-shaped relationship between stress hyperglycemia ratio and delirium risk in critically ill patients: A population-based study.PloS one · 2026Article
- The relation between postoperative cognitive disorders and brain damage biomarkers after major urologic surgery: a prospective cohort study.Perioperative medicine (London, England) · 2025Article
- Role of glia in delirium: proposed mechanisms and translational implications.Molecular psychiatry · 2025Review
- Neuron-specific enolase and Tau protein as biomarkers for sepsis-associated delirium: a cross-sectional pilot study.Einstein (Sao Paulo, Brazil) · 2025Article
- Updated insights into the NLRP3 inflammasome in postoperative cognitive dysfunction: emerging mechanisms and treatments.Frontiers in aging neuroscience · 2024Review
- Post-Operative Delirium and Cognitive Dysfunction in Aged Patients Undergoing Cardiac Surgery: A Randomized Comparison between Two Blood Oxygenators.Bioengineering (Basel, Switzerland) · 2023Article
- Association between Neuron-Specific Enolase, Memory Function, and Postoperative Delirium after Transfemoral Aortic Valve Replacement.Journal of cardiovascular development and disease · 2023Article
- Circulating biomarkers in perioperative management of cancer patients.Precision clinical medicine · 2023Review
- 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
- Brain injury biomarkers do not predict delirium in acutely ill older patients: a prospective cohort study.Scientific reports · 2023Article
- Biomarkers of delirium risk in older adults: a systematic review and meta-analysis.Frontiers in aging neuroscience · 2023Review
- The effect of parecoxib sodium on postoperative delirium in elderly patients with hip arthroplasty.Frontiers in pharmacology · 2023Article
- Effects of individualized PEEP on postoperative delirium among older patients in prone position: study protocol for a prospective randomized controlled trial.BMC neurology · 2022Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDelirium is the most common central nervous system complication after surgery. Detection of phosphorylated neurofilament heavy subunit in the serum reflects axonal damage within the central cervous system and is associated with the severity of postoperative delirium. Neuron-specific enolase and S100 calcium-binding protein β have been identified as possible serum biomarkers of postoperative delirium. This study examined the association of the levels of these markers with incidence of postoperative delirium and detection of phosphorylated neurofilament heavy subunit.
methodsThis study represents a post hoc analysis of 117 patients who participated in a prospective observational study of postoperative delirium in patients undergoing cancer surgery. Patients were clinically assessed for development of postoperative delirium within the first five days of surgery. Serum levels of phosphorylated neurofilament heavy subunit, neuron-specific enolase, and S100 calcium-binding protein β levels were measured on postoperative day 3.
resultsForty-one patients (35%) were clinically diagnosed with postoperative delirium. Neuron-specific enolase level (P < 0.0001) and the proportion of patients positive for phosphorylated neurofilament heavy subunit (P < 0.0001) were significantly higher in the group of patients with postoperative delirium. Neuron-specific enolase level discriminated between patients with and without clinically diagnosed postoperative delirium with significantly high accuracy (area under the curve [AUC], 0.87; 95% confidence interval [CI], 0.79-0.95; P < 0.0001). Neuron-specific enolase level was associated with incidence of postoperative delirium independently of age (adjusted odds ratio, 8.291; 95% Cl, 3.506-33.286; P < 0.0001). The AUC for the serum neuron-specific enolase level in detecting phosphorylated neurofilament heavy subunit was significant (AUC, 0.78; 95% CI, 0.66-0.90; P < 0.0001).
conclusionElevated serum neuron-specific enolase was associated with postoperative delirium independent of age as well as detection of phosphorylated neurofilament heavy subunit in serum. Serum neuron-specific enolase and phosphorylated neurofilament heavy subunit might be useful as biomarkers of postoperative delirium.
trial registrationUniversity Medical Information Network (UMIN) trial ID: UMIN000010329; https://clinicaltrials.gov/.
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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.