Evidence map›Paper›PMID 40101134›Full record

SynthesisInternational journal of surgery (London, England)2025

Cerebrospinal fluid biomarkers of neuroinflammation and postoperative neurocognitive disorders in patients undergoing orthopedic surgery: a systematic review and meta-analysis.

Huiru Feng, Yang Liu, Xue Wang, Chunxiu Wang, Tianlong Wang

Registry-linked trialAbstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in International journal of surgery (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07655687 (Intraoperative Targeted Temperature Management on Delayed Neurocognitive Recovery in Older Patients After Major Cancer Surgery), which is not on this map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
–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.

NCT07655687 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Intraoperative Targeted Temperature Management on Delayed Neurocognitive Recovery in Older Patients After Major Cancer Surgery: a Multicenter Randomized Trial

TypeinterventionalSponsorPeking University First HospitalRan2026 to 2028Enrolled1,512ConditionsElderly Patients, Cancer Surgery, Hypothermia, Accidental, Targeted Temperature ManagementArmsTarget temperature management, Routine thermal management
3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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  3. Article
  4. Review
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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

5 authors.

Huiru FengDepartment of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Yang LiuDepartment of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Xue WangDepartment of Medical Information Research Lab/Medical Libarary, Xuanwu Hospital, Capital Medical University, Beijing, China.
Chunxiu WangDepartment of Evidence-based Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
Tianlong WangDepartment of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPostoperative neurocognitive disorders (PNDs) are common postoperative complications that can hinder patients' postoperative recovery. Various studies have investigated the correlations between PNDs and cerebrospinal fluid (CSF) neuroinflammatory biomarkers in orthopedic patients. However, combined evidence is required to confirm the homogeneity and robustness of these findings.

methodsObservational studies were searched to explore the associations between PNDs and these biomarkers in orthopedic patients. A comprehensive study retrieval was performed in MEDLINE (via OVID), EMBASE, and the Cochrane Library without any restrictions on language or date. Subgroup and sensitivity analyses were performed to confirm robustness of the results.

resultA total of 27 articles were included in this study. Significant concentration differences were found between PNDs and non-PNDs groups in the majority of preoperative CSF neuroinflammatory biomarkers, particularly in patients with postoperative delirium (POD) and delayed neurocognitive recovery (dNCR). Moderate quality evidence identified that increased preoperative CSF levels of t-Tau (OR: 1.008, 95%CI: 1.005-1.010) and p-Tau (OR: 1.077, 95%CI: 1.042-1.078), along with decreased Aβ42 level (OR: 0.998, 95% CI: 0.997-0.999), were risk factors for POD in orthopedic patients. Low quality evidence suggested that preoperative CSF level of Aβ42/t-Tau was a valuable predictive biomarker for dNCR.

conclusionDifferent subtypes of PNDs after orthopedic surgery have different CSF biomarkers, with POD having the most and postoperative neurocognitive disorder (POCD) having the fewest. Studies concerning dNCR and POCD are needed to investigate their correlations with these biomarkers. Meanwhile, studies concerning diagnostic tests are also highly needed to help screen for practical biomarkers and analyze these biomarkers from a more comprehensive perspective.

Indexed as

Neurocognitive DisordersNeuroinflammatory DiseasesOrthopedic ProceduresPostoperative Cognitive ComplicationsPostoperative ComplicationsBiomarkersHumansBiomarkersamyloid beta-peptidesdeliriumneurofilament proteinsorthopedic surgerypostoperative cognitive complicationstau proteins

Identifiers

PMID40101134
PMCPMC12165501

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Registered trials

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.