Anesthesia and surgery-induced elevation of CSF sTREM2 is associated with early cognitive dysfunction after thoracoabdominal aortic dissection surgery
Kexin Wang, Xuezhao Cao, Zhe Li, Sidan Liu, Yongjian Zhou, Lili Guo, Pengli Li
Abstract
Abstract Purpose Soluble triggering receptor expressed on myeloid cells 2 (sTREM2) concentration is increased in cerebrospinal fluid (CSF) in early symptomatic phase of Alzheimer’s disease (AD). This study investigated whether CSF sTREM2 has a relationship with early cognitive dysfunction following surgery in cardiac surgery patients. Methods A total of 82 patients undergoing thoracoabdominal aortic replacement were recruited in this study. Neuropsychological testing battery was conducted before and after surgery. Postoperative cognitive dysfunction (POCD) was defined as a Z-score > 1.96 on at least 2 different tests or Telephone Interviews for Cognitive Status-Modified (TICS-M) score < 27. The CSF and serum sTREM2, Aβ 42 , T-tau and P-tau were collected and measured by ELISA on day before surgery and postoperative day 3. Results Patients were classified into POCD ( n = 34) and non-POCD ( n = 48) groups according to Z-score. Compared to non-POCD group, the levels of CSF sTREM2 ( p < 0.001) and serum sTREM2 ( p = 0.001) were significantly higher in POCD group on postoperative day 3. The levels of Aβ 42 ( p = 0.005) and Aβ 42 /T-tau ratio ( p = 0.036) were significantly lower in POCD group on postoperative day 3. Multivariate logistic regression analysis revealed that higher value of postoperative CSF sTREM2 (odds ratio: 1.06, 95% confidence interval: 1.02–1.11, p = 0.009), age (OR: 1.15, 95%CI: 1.03–1.28, p = 0.014) and POD duration (OR: 2.47, 95%CI: 1.15–5.29, p = 0.02) were the risk factors of POCD. Conclusion This study indicates that anesthesia and surgery-induced elevation of CSF sTREM2 is associated with an increased risk of early cognitive dysfunction following surgery.