Evidence map›Paper›PMID 42143058›Full record

ArticleTranslational psychiatry2026

Postoperative delirium in hip fracture patients linked to epigenetic alterations in inflammatory and immune pathways: a genome-wide DNA methylation study.

Tomoteru Seki, Shota Nishitani, Yoshitaka Nishizawa, Kyosuke Yamanishi, Akiyoshi Shimura, Tsuyoshi Nishiguchi, Takaya Ishii, Bun Aoyama, Therese Anne Santiago, Nathan James Phuong and 9 more

Abstract read
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In one paragraph

Article in Translational psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

19 authors.

Tomoteru SekiDepartment of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Palo Alto, CA, USA.ORCID http://orcid.org/0000-0003-2593-7118
Shota NishitaniDepartment of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Palo Alto, CA, USA.
Yoshitaka NishizawaDepartment of Psychiatry, School of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan.
Kyosuke YamanishiDepartment of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Palo Alto, CA, USA.
Akiyoshi ShimuraDepartment of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Palo Alto, CA, USA.
Tsuyoshi NishiguchiDepartment of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Palo Alto, CA, USA.
Takaya IshiiDepartment of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Palo Alto, CA, USA.ORCID http://orcid.org/0000-0001-6026-8664
Bun AoyamaDepartment of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Palo Alto, CA, USA.
Therese Anne SantiagoDepartment of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Palo Alto, CA, USA.
Nathan James PhuongDepartment of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Palo Alto, CA, USA.ORCID http://orcid.org/0009-0003-8374-782X
Nipun GorantlaDepartment of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Palo Alto, CA, USA.
Hieu Dinh NguyenDepartment of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Palo Alto, CA, USA.
Ryo TakedaAdvanced Clinical Specialist Center, Kameda Medical Center, Kamogawa, Chiba, Japan.
Takashi KameokaDepartment of Orthopedics, Kameda Medical Center, Kamogawa, Chiba, Japan.
Takeshi InoueDepartment of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan.ORCID http://orcid.org/0000-0001-5248-1289
Daisuke SugiyamaDepartment of Anesthesia, Kameda Medical Center, Kamogawa, Chiba, Japan.
Kenichi UedaDepartment of Anesthesia, Kameda Medical Center, Kamogawa, Chiba, Japan.
Takehiko YamanashiDepartment of Neuropsychiatry, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan. yamatake@tottori-u.ac.jp.ORCID http://orcid.org/0000-0002-3881-8997
Gen ShinozakiDepartment of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Palo Alto, CA, USA. gens@stanford.edu.ORCID http://orcid.org/0000-0001-6129-2789

Funding

Epigenetics Biomarker of Post Operative Delirium and Long Term Cognitive Decline among Elderly Dementia PatientsR01AG084710 · NIA · STANFORD UNIVERSITY · PI Gen Shinozaki · 2024 to 2026
$3.4M
Identification of Epigenetics Correlates between Brain and Peripheral TissuesR01MH119165 · NIMH · UNIVERSITY OF IOWA · PI SHINOZAKI, GEN · 2020 to 2024
$3.0M
NIA NIH HHS R01 AG084710NIMH NIH HHS R01 MH119165
6 · The paper itself

Abstract

Delirium is a common yet underdiagnosed condition in elderly hospitalized patients. The lack of effective diagnostic and therapeutic methods can be attributed to the limited understanding of its pathophysiology. Delirium has recently been reported to be linked to neuroinflammation and epigenetic changes. The aim of this study was to validate the pathways in a larger cohort with a uniform type of surgery, while rigorously adjusting for potential covariates. This study primarily investigated DNA methylation (DNAm) changes before and after surgery in postoperative delirium (POD) among older adults having undergone femoral fracture surgery. After propensity analysis, 65 subjects were divided into 2 subgroups; one consisted of subjects who had blood samples collected preoperatively and on postoperative day 0, and the other consisted of those who had samples collected preoperatively and on postoperative day 3. We performed differential methylation analysis and enrichment analysis on each subgroup. Enrichment analysis using CpGs that exhibited substantial DNAm changes between pre- and postoperative day 0 samples in POD cases showed inflammation- and immunity-related pathways such as "leukocyte mediated immunity" and "NF-kappa B signaling pathway." Inflammation- and immunity-related pathways became less noticeable between pre- and postoperative day 3 samples. Inflammation- and immunity-related pathways showed in this study align with previous studies across diverse populations, reinforcing the role of inflammation- and immunity-related epigenetic mechanisms in delirium including POD. Notably, these DNAm changes were potentially transient, corresponding to the typical onset of delirium, suggesting their potential as biomarkers for early diagnosis.

Indexed as

DeliriumDNA MethylationEpigenesis, GeneticHip FracturesInflammationPostoperative ComplicationsAgedAged, 80 and overFemaleGenome-Wide Association StudyHumansMaleSignal Transduction

Identifiers

PMID42143058
PMCPMC13347018

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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.