Evidence map›Paper›PMID 42157125›Full record

Observational studyBMC geriatrics2026

CSF neurofilament light chain concentration in patients with delirium following hip fracture: a multicenter prospective study.

Irit Titlestad, Leiv Otto Watne, Kaj Blennow, Henrik Zetterberg, Marius Myrstad, Emilija Dunjic, Christian Thomas Pollmann, Adi Karabeg, Lene B Solberg, Ane-Victoria Idland and 5 more

Abstract readMulticenter StudyObservational Study
In one paragraph

Observational study in BMC geriatrics, 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

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

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

15 authors.

Irit TitlestadDepartment of Clinical Medicine, University of Bergen, Bergen, Norway. Irit.titlestad@uib.no.
Leiv Otto WatneOslo Delirium Research Group, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Kaj BlennowDepartment of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Henrik ZetterbergDepartment of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Marius MyrstadDepartment of Internal Medicine, Baerum Hospital Vestre Viken Hospital Trust, Gjettum, Norway.
Emilija DunjicDepartment of Anesthesiology, Baerum Hospital, Baerum, Norway.
Christian Thomas PollmannDepartment of Orthopaedic Surgery, Akershus University Hospital, Lørenskog, Norway.
Adi KarabegDepartment of Orthopedic Surgery, Akershus University Hospital, Kongsvinger, Norway.
Lene B SolbergDivision of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.
Ane-Victoria IdlandOslo Delirium Research Group, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Allan GulestølDepartment of Anaesthesiology, Oslo University Hospital, Oslo, Norway.
Aasmund GodøDepartment of Anaesthesiology, Diakonhjemmet Hospital, Oslo, Norway.
Bjørn Erik NeerlandOslo Delirium Research Group, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Lasse M GiilNeuro-SysMed, Department of Internal Medicine, Haraldsplass Deaconess Hospital Bergen, Ulriksdal 8, Bergen, 5009, Norway.
Nathalie Bodd HalaasOslo Delirium Research Group, Institute of Clinical Medicine, University of Oslo, Oslo, Norway. nathalbh@uio.no.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStudies suggest delirium is associated with neuronal injury, which may further raise mortality risk. Neuronal injury can be assessed by measuring neurofilament light chain (NFL) concentrations in cerebrospinal fluid (CSF). This study aimed to investigate the association of CSF-NfL with delirium and mortality in patients with hip fracture.

methodsThe study comprised two prospective cohorts of 548 hip fracture patients with per-operative CSF samples. CSF-NfL concentrations were measured using a commercial ELISA. Delirium was assessed daily from admission until the fifth postoperative day and survival censored at one year. The multivariable analyses (Logistic and Cox regression) were adjusted for age, sex, glomerular filtration rate, dementia status, comorbidity, and Activities of Daily Living. Additionally, Cox regression was adjusted for delirium.

resultsIn total, 259 (52%) patients developed delirium. In univariate analysis, CSF-NfL was higher among patients with delirium (2116 pg/ml versus 1366 pg/ml, odds ratio (OR) 2.21, (95% confidence interval (CI) [1.75,2,78], P < 0.001). In adjusted analysis, CSF-NfL was not significant (OR 1.29, [0.92,1.81], P = 0.128) and only remained significantly associated with delirium in the subgroup of patients without dementia (OR 1.84, [1.17, 2.89], P = 0.007). In unadjusted analysis of mortality, CSF-NfL was significantly associated with death at one year (hazard ratio (HR) 1.60, [1.37, 1.87], P < 0.001) but not in adjusted analysis (HR 1.03 [0.84, 1.26], P = 0.736).

conclusionsOur findings show that CSF-NfL concentrations were associated with delirium in patients without pre-existing dementia, suggesting possible undiagnosed dementia or, less likely, delirium-related neuronal injury. The CSF-NfL-associated mortality hazard was non-significant after adjustment, mainly for delirium. Thus, the clinical context must be considered when studying CSF-NfL and delirium.

Indexed as

DeliriumHip FracturesNeurofilament ProteinsAgedAged, 80 and overBiomarkersCohort StudiesFemaleHumansMaleNorwayProspective StudiesBiomarkersneurofilament protein LNeurofilament ProteinsCerebrospinal fluidDeliriumMortalityNeurofilament light

Identifiers

PMID42157125
PMCPMC13390360

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Registered trials

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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.