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Inflammatory markers in postoperative cognitive dysfunction for patients undergoing total hip arthroplasty: a meta-analysis

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Abstract

Background

Postoperative cognitive dysfunction (POCD) is a poorly understood disorder, very common even after total hip arthroplasty (THA). It is widely considered that inflammation response play a role in the pathogenesis of POCD.

Aims

The aim of the present study was to investigate whether inflammation cytokine concentrations could serve as biomarkers for POCD in patients undergoing THA.

Methods

A systematic search of databases was conducted to retrieve publications measuring circulating inflammatory markers of patients with and without POCD after THA. Inflammatory markers identified in more than two studies were pooled. The standardized mean difference (SMD) and the 95% confidence interval (95% CI) were calculated for each outcome. Fail-safe N statistics was calculated to estimate possible publication bias.

Results

The pooled incidence rate of POCD after THA by combining 11 cohort studies was 31%. A total of five inflammatory markers, CRP, S-100B, IL-1β, IL-6 and TNF-α, were assessed. Significantly higher pre-operative CRP (P = 0.012) and S-100B (P < 0.0001) as well as post-operative CPR (P = 0.005) and IL-6 (P < 0.0001) at 6 h were found in POCD compared with non-POCD patients undergoing THA. Fail-safe N statistics revealed that these results are robust.

Discussion

The current evidence suggests that some of the inflammatory markers, including CRP, S-100B, and IL-6, were correlated with the occurrence of POCD after THA.

Conclusion

Monitor of inflammatory markers might help early diagnosis of POCD after THA and development of preventive strategies.

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Data availability

All data generated or analysed during this study are included in this published article and its supplementary information files.

Change history

  • 03 February 2022

    article category has been updated.

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Funding

This research was supported by 2018 Annual Shantou Science and Technology Plan Project, Shan Fuke [2018] No. 120

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Authors and Affiliations

  1. Department of Anesthesiology, Chaonan Minsheng Hospital of Shantou, National Highway 324, Xiashan Liannan Town, Chaonan District, Shantou, 515100, China

    Chunmei Fu, Weibin Zhong & Haihong Chen

  2. Department of Anesthesiology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Chuangdong, Shantou, 515041, China

    Jincheng Lin

  3. Department of Pathology, Chaonan Minsheng Hospital of Shantou, National Highway 324, Xiashan Liannan Town, Chaonan District, Shantou, 515100, China

    Guoliang Gong

  4. Department of Pathology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Chuangdong, Shantou, 515041, China

    Guoliang Gong & Xiaowei Luo

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  1. Chunmei Fu
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  2. Jincheng Lin
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  4. Weibin Zhong
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Contributions

GLG and CMF conceived and designed the analysis; WBZ, HBC, and XWL acquired the data; JCL and GLG analyzed and interpreted the data; CMF drafted and revised the article; all author contributed to the final approval of the manuscript.

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Correspondence to Guoliang Gong.

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Fu, C., Lin, J., Gong, G. et al. Inflammatory markers in postoperative cognitive dysfunction for patients undergoing total hip arthroplasty: a meta-analysis. Aging Clin Exp Res 34, 277–288 (2022). https://doi.org/10.1007/s40520-021-01919-7

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