Evidence map›Paper›PMID 39495288›Full record

ArticleJournal of anesthesia2025

Preoperative hypoxic biomarkers and postoperative delirium in patients with obstructive sleep apnea.

Martin Breitkopf, Elena Ahrens, Matthias L Herrmann, Stephanie Heinemann, Olivia Kuester, Haobo Ma, Andreas Walther, Christine Thomas, Gerhard W Eschweiler, Christine A F von Arnim and 1 more

Abstract read
In one paragraph

Article in Journal of anesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Observational
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Martin BreitkopfDepartment of Anesthesiology and Intensive Care, Katharinenhospital Klinikum Stuttgart, Stuttgart, Germany.
Elena AhrensDepartment of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA.
Matthias L HerrmannDepartment of Neurology and Clinical Neuroscience, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.
Stephanie HeinemannDepartment of Geriatrics, University Medical Center Göttingen, Göttingen, Germany.
Olivia KuesterDepartment of Neurology, Universitaetsklinikum Ulm, Ulm, Germany.
Haobo MaDepartment of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA.
Andreas WaltherDepartment of Anesthesiology and Intensive Care, Katharinenhospital Klinikum Stuttgart, Stuttgart, Germany.
Christine ThomasDepartment of Old Age Psychiatry and Psychotherapy, Klinikum Stuttgart, Krankenhaus Bad Cannstatt, Stuttgart, Germany.
Gerhard W EschweilerGeriatric Center, Department of Psychiatry and Psychotherapy, Tübingen University Hospital, Tübingen, Germany.
Christine A F von ArnimDepartment of Geriatrics, University Medical Center Göttingen, Göttingen, Germany.
Soeren WagnerDepartment of Anesthesiology and Intensive Care, Katharinenhospital Klinikum Stuttgart, Stuttgart, Germany. soeren.wagner@tum.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePostoperative delirium (POD) in patients with obstructive sleep apnea (OSA) is associated with increased mortality and healthcare costs. In this study, we investigated the association of OSA risk, serum biomarkers for central nervous ischemia (S100B and NSE), and POD.

methodsAfter research ethics approval, patients completed the STOP BANG assessment before undergoing elective surgery. Blood was drawn for S100B and NSE measurement, and cognitive performance was tested using the Montreal Cognitive Assessment (MoCA) at study admission and postoperatively at discharge. Delirium assessment was performed using the Nursing Delirium Screening Scale (NuDESC) and the Confusion Assessment Method (CAM).

resultsOne hundred twenty-four enrolled patients were separated into three OSA-risk groups based on STOP BANG score testing (low risk, n = 22; intermediate risk, n = 67; high risk, n = 35). Preoperative NSE values increased with OSA risk (NSE in ng/ml; mean [range]; low risk: 15.6 [9.2-44.3]; intermediate risk: 21.8 [7.6-114.1]; high risk: 29.2 [10.1-151]; p = 0.039). Postoperative MoCA and NuDESC assessments were not different between the OSA-risk groups. We found a decreasing incidence for POD with increasing OSA risk (positive CAM: low risk: 18.1%, intermediate risk: 12.0%; high risk: 11.5%, p = 0.043). However, this was no longer detectable in a complete case analysis. In patients with POD, postoperative ischemic biomarker values were not different between OSA-risk groups.

conclusionWe found a trend of decreasing POD incidence with increasing OSA risk, which was not robust in a complete case analysis. Our results possibly support the phenomenon of hypoxic preconditioning.

Indexed as

DeliriumHypoxiaPostoperative ComplicationsS100 Calcium Binding Protein beta SubunitSleep Apnea, ObstructiveAdultAgedBiomarkersFemaleHumansMaleMiddle AgedProspective StudiesRisk FactorsBiomarkersS100B protein, humanS100 Calcium Binding Protein beta SubunitBiomarkerHypoxic preconditioningOSAPostoperative delirium

Identifiers

PMID39495288
PMCPMC11782433

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.