Postoperative plasma 8-iso-prostaglandin F2α levels are associated with delirium and cognitive dysfunction in elderly patients after hip fracture surgery

Background: Oxidative stress may be involved in occurrence of postoperative delirium (POD) and cognitive dysfunction (POCD). 8-iso-Prostaglandin F2 alpha (8-iso-PGF2 alpha), an isoprostane derived from arachidonic acid via lipid peroxidation, is considered a gold standard for measuring oxidative stress. The present study aimed to investigate the ability of postoperative plasma 8-iso-PGF2 alpha levels to predict POD and POCD in elderly patients undergoing hip fracture surgery. Methods: Postoperative plasma 8-iso-PGF2 alpha levels of 182 patients were measured by an enzyme-linked immunosorbent assay. We assessed the relationships between plasma 8-iso-PGF2 alpha levels and the risk of POD and POCD using a multivariate analysis. Results: Plasma 8-iso-PGF2 alpha levels and age were identified as the independent predictors for POD and POCD. Based on areas under receiver operating characteristic curve, the predictive values of 8-iso-PGF2 alpha were obviously higher than those of age for POD and POCD. In a combined logistic-regression model, 8-iso-PGF2 alpha significantly enhanced the areas under curve of age for prediction of POD and POCD. Conclusions: Postoperative plasma 8-iso-PGF2 alpha levels may have the potential to predict POD and POCD in elder patients undergoing hip fracture surgery. (C) 2016 Elsevier B.V. All rights reserved.