Table 2.
Association between Neurofilament Light Chain and Postoperative Delirium Incidence, Days and Severity
| Delirium | Delirium Days* | Sum CAM-S* (per point) | ||
|---|---|---|---|---|
| Quartile | NFL(pg/ml) | Adjusted OR (95% CI) | Days (95% CI) | Score (95% CI) |
| PREOP (n=53 matched pairs) | ||||
| Q1 | ≤20.76 | Reference | Reference | Reference |
| Q2 | 20.77–29.06 | 1.39 (0.41–4.74) | −0.04 (−0.57, 0.49) | 0.03 (−5.22, 5.28) |
| Q3 | 29.07–44.38 | 1.05 (0.35–3.14) | 0.03 (−0.54, 0.61) | 1.17 (−4.56, 6.89) |
| Q4 | ≥44.39 | 3.71 (1.09–12.58) | 0.47 (−0.16, 1.10) | 7.82 (1.60, 14.04) |
| p for trend | 0.06 | 0.35 | 0.02 | |
| POD2 (n=47 matched pairs) | ||||
| Q1 | ≤28.08 | Reference | Reference | Reference |
| Q2 | 28.09–40.21 | 3.97 (0.90–17.47) | 0.11 (−0.43, 0.65) | 1.02 (−4.96, 7.00) |
| Q3 | 40.22–54.75 | 4.67 (1.20–18.15) | −0.14 (−0.74, 0.45) | 1.40 (−5.04, 7.85) |
| Q4 | ≥54.76 | 8.83 (1.88–41.36) | 1.04 (0.49, 1.60) | 9.34 (3.22, 15.46) |
| p for trend | <.01 | <.01 | <.01 | |
In all models, we adjusted for baseline covariables likely to be related to delirium and cognitive decline, including age, sex, vascular comorbidity, baseline general cognitive performance and Apolipoprotein E4 carrier status
Delirium is expressed as an adjusted odds ratio (null=1) whereas delirium days and delirium severity (sum of CAM-S) are expressed as the increase in delirium days or CAM-S points for patients in a given quartile (Q) relative to patients in Q1 (null=0)
Abbreviations: CAM-S=Confusion Assessment Method-Severity, GDS=Geriatric Depression Scale; IQCODE= Informant Questionnaire on Cognitive Decline in the Elderly, NfL=neurofilament light chain, POD2=postoperative day 2, PREOP=preoperative, Q=quartile
Bold indicates significant at P < .05