Evidence map›Paper›PMID 40775336›Full record

ArticlePerioperative medicine (London, England)2025

Soluble DLL1 as an Indicator of acute kidney injury and postoperative delirium following cardiac surgery: a secondary analysis of a prospective study.

Thomas Simon Zajonz, Fabian Edinger, Melanie Markmann, Anna-Lena Schreiner, Frauke Beckert, Markus A Weigand, Florian Uhle, Bernd Niemann, Michael Sander, Christian Koch and 1 more

Abstract read
In one paragraph

Article in Perioperative medicine (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Research progress on biomarkers for acute kidney injury in children.Pediatric nephrology (Berlin, Germany) · 2026
    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.

Thomas Simon ZajonzDepartment of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, University Hospital of Giessen and Marburg, Giessen, Germany. Thomas.s.zajonz@chiru.med.uni-giessen.de.
Fabian EdingerDepartment of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, University Hospital of Giessen and Marburg, Giessen, Germany.
Melanie MarkmannDepartment of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, University Hospital of Giessen and Marburg, Giessen, Germany.
Anna-Lena SchreinerDepartment of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, University Hospital of Giessen and Marburg, Giessen, Germany.
Frauke BeckertDepartment of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, University Hospital of Giessen and Marburg, Giessen, Germany.
Markus A WeigandDepartment of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany.
Florian UhleDepartment of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany.
Bernd NiemannDepartment of Adult and Pediatric Cardiac and Vascular Surgery, University Hospital Giessen and Marburg Campus Giessen, Giessen, Hessen, Germany.
Michael SanderDepartment of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, University Hospital of Giessen and Marburg, Giessen, Germany.
Christian KochDepartment of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, University Hospital of Giessen and Marburg, Giessen, Germany.
Emmanuel SchneckDepartment of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, University Hospital of Giessen and Marburg, Giessen, Germany.

Funding

§2 of the Cooperation Agreement of the State of Hessen, Germany, and the University Hospital of Giessen and Marburg, Hessen, Germany 18-2016GI
6 · The paper itself

Abstract

backgroundAcute kidney injury (AKI) displays a common complication after cardiac surgery and must be diagnosed as early as possible. Soluble delta-like protein 1 (sDLL1) was originally evaluated as a sepsis biomarker but might also indicate other adverse outcomes. This study aims to investigate sDLL1 levels, examining its potential relationship with AKI and postoperative delirium (POD) after cardiac surgery and its predictive value.

methodsThis secondary analysis of a prospective observational trial included elective cardiac surgery patients. ELISA was used for the quantification of sDLL1. Statistical analysis involved repeated measures ANOVA and Pearson's correlation to assess associations between sDLL1 levels, renal, and inflammatory parameters. Receiver operating curves were used for prediction analysis.

resultsNinety patients were included in the study. Compared to patients without AKI, those with AKI (6.1%) showed significantly elevated plasma levels of sDLL1 postoperatively (no AKI 6308.49 [5121.27-7955.28], AKI 7,714.77 [7151.06-10,514.73] ng/mL; p = 0.01). Postoperative sDLL1 levels showed only a low predictive value for AKI (AUCROC 0.63, sensitivity 0.91, specificity 0.53). Postoperative sDLL1 measurements were also significantly elevated in patients with POD (23.3%). Further, postoperative sDLL1 plasma levels showed a moderate prediction for the identification of POD (AUCROC 0.72, sensitivity 0.64 specificity 0.73).

conclusionThis study demonstrates that sDLL1 provides moderate predictive value for AKI and POD after cardiac surgery and may provide valuable insights into postoperative complications. sDLL1 levels increase independently of CPB type, suggesting a role in the inflammatory response to the cardiopulmonary bypass and surgical stress rather than specific renal injury.

trial registrationDRKS00010959.

Indexed as

BiomarkersDelirium surgeryInflammationNeuropsychological testsPostoperative cognitive complicationsRenal insufficiencyRisk

Identifiers

PMID40775336
PMCPMC12330148

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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.