Journal Article

DZNE-2026-00418

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Prediction of postoperative delirium after cardiac surgery by the interplay between preoperative plasma p-tau181 and IL-6 and heart-brain axis related factors: results from the prospective observational study FINDERI.

Hansen, N. ; Knopp, C. M. ; Esselmann, H. ; Celano, C. M. ; Derad, C. ; Asendorf, T. ; Chebbok, M. ; Heinemann, S. ; Malik, I. ; Marcos Morgado, B.Extern* ; Becker, M.-M. ; Günther, I. ; Krasiuk, I. ; Packroß, K. ; Rediske, A. I. ; Süttmann, N. P. ; Titsch, T. ; Kutschka, I. ; Baraki, H. ; Wiltfang, J.DZNE* ; von Arnim, C. A. F. ; Sadlonova, M. ; investigators, F. (Collaboration Author) ; Wiesent, A. (Contributor) ; Jahn-Brodmann, A. (Contributor) ; Thiel, A.-C. (Contributor) ; Gaß, A. (Contributor) ; Marcos Morgado, B. (Contributor)Extern* ; Schott, B. (Contributor)Extern* ; Albert, B. (Contributor) ; Eberhard, C. (Contributor) ; von Arnim, C. A. F. (Contributor) ; Knopp, C. M. (Contributor) ; Bauer, F. E. (Contributor) ; Schmitz, J. (Contributor) ; Ehrentraut, J. (Contributor) ; Hohberg, M. (Contributor) ; Santander, M. J. (Contributor) ; Alexy, M. (Contributor) ; Dornieden, M. (Contributor) ; Knierim, M. (Contributor) ; Richter, M. (Contributor) ; Hotheit, M. (Contributor) ; Moser, M. (Contributor) ; Schröder, M. F. (Contributor) ; Itting, P. T. (Contributor) ; Arentz, R. (Contributor) ; Kastenbauer, S. (Contributor) ; Martinez, S. (Contributor) ; Johannes, M. (Contributor) ; Doerfler, S. (Contributor) ; Chiwakata, T. (Contributor) ; Kruck, T. M. (Contributor)

2026
Springer Nature [London]

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Please use a persistent id in citations: doi:10.1038/s41380-025-03412-3

Abstract: Postoperative delirium (POD) following cardiac surgery is a severe complication. There is evidence of a link between neuroinflammation and neurodegeneration in POD. We investigated the preoperative proinflammatory interleukin-6 (IL-6) and neuronal damage marker phosphorylated tau protein 181 (p-tau181) to POD while considering preoperative heart-brain axis related factors. The prospective FINd DElirium RIsk factors (FINDERI) is an observational study in patients undergoing cardiac surgery. Biomarkers IL-6 and p-tau181 were measured in blood samples. For statistics, we utilized multiple logistic regression analyses and advanced machine learning techniques. In 491 patients, 106 (21.6%) developed POD. The age of patients with POD was significantly higher than that of patients without POD (p < 0.001). Preoperative IL-6 and p-tau181 levels independently predicted POD [IL-6: area under the curve (AUC) = 0.605, p < 0.005; p-tau181: AUC = 0.641, p < 0.0001)]. A multiple logistic regression analysis of preoperative log-transformed biomarkers levels (p-tau181, IL-6), female sex and cognitive performance increased the AUC (0.710, p < 0.0001) in predicting POD. We created a decision tree prediction model including preoperative p-tau181, IL-6, and the severity of mitral valve disease (training data: AUC = 0.672, p < 0.0001; validation data: AUC = 0.642, p < 0.05). The LASSO regression showed an increased AUC in the training (0.751, p < 0.0001) and validation dataset (0.652, p < 0.05). Our results demonstrate that the combined assessment of preoperatively measured p-tau181 and IL-6, preoperative mitral valve disease, cognitive performance and female sex, significantly predicts POD. These findings provide evidence that neuroinflammation and neuronal cell damage are associated with POD.

Keyword(s): Humans (MeSH) ; Female (MeSH) ; Male (MeSH) ; Interleukin-6: blood (MeSH) ; Aged (MeSH) ; Cardiac Surgical Procedures: adverse effects (MeSH) ; Prospective Studies (MeSH) ; tau Proteins: blood (MeSH) ; Biomarkers: blood (MeSH) ; Middle Aged (MeSH) ; Postoperative Complications: blood (MeSH) ; Delirium: blood (MeSH) ; Delirium: etiology (MeSH) ; Delirium: diagnosis (MeSH) ; Risk Factors (MeSH) ; Brain: metabolism (MeSH) ; Preoperative Period (MeSH) ; Phosphorylation (MeSH) ; Interleukin-6 ; tau Proteins ; Biomarkers ; IL6 protein, human ; MAPT protein, human

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Contributing Institute(s):

1. Molecular biomarkers for predictive diagnostics of neurodegenerative diseases (AG Wiltfang)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

Appears in the scientific report 2026

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Database coverage:
; ; ; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Life Sciences ; DEAL Springer ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 10 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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