SynthesisFrontiers in aging neuroscience2026
Circulating and cerebrospinal fluid soluble TREM2 levels and risk of perioperative neurocognitive disorders in surgical patients: a systematic review and meta-analysis.
Synthesis in Frontiers in aging neuroscience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Perioperative neurocognitive disorders (PND), including postoperative delirium (POD) and cognitive dysfunction (POCD), are common surgical complications in older adults. Neuroinflammation from microglial activation is a key mechanism. Soluble TREM2 (sTREM2) is a blood/CSF biomarker reflecting microglial activity. Existing studies on sTREM2 and PND risk have been inconsistent. We conducted the first meta-analysis to quantify this association. Methods: We searched PubMed, Web of Science, Scopus, APA PsycInfo, Embase, the Cochrane Library (CENTRAL), and https://www.ClinicalTrials.gov, CNKI, and Wanfang Data up to August 2026 for observational studies reporting perioperative sTREM2 levels in surgical patients with/without PND. Primary outcome was standardized mean difference (SMD) in sTREM2 between PND cases and controls, using a random-effects model. Heterogeneity was assessed via Results: Eight studies (1,154 patients) were included; seven with quantitative data (1,072 patients) were meta-analyzed. Patients with PND had higher sTREM2 levels than controls (SMD = 0.44, 95% CI: 0.02 to 0.87, Conclusion: Elevated perioperative sTREM2 concentrations in cerebrospinal fluid, but not in peripheral blood, showed a modest positive association with PND risk. sTREM2 represents a candidate biomarker for perioperative cognitive complications; however, the very low certainty of the underlying evidence precludes definitive conclusions. Large-scale standardized studies are needed to validate its clinical utility. Systematic review registration: The systematic review was prospectively registered in PROSPERO (Unique Identifier: CRD420261386903), https://www.crd.york.ac.uk/prospero/.
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