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Serum galectin-3 levels and delirium among postpartum intensive care unit women.

ABSTRACT: OBJECTIVE:Inflammation correlates with delirium. Galectin-3 is a proinflammatory protein. This study aimed to determine relation of serum galectin-3 levels to delirium of postpartum intensive care unit (ICU) women. MATERIALS AND METHODS:In this prospective observational study, serum galectin-3, S100B, and C-reactive protein levels of 412 postpartum ICU women and 412 healthy women were measured. Delirium and Acute Physiology and Chronic Health Care Evaluation II (APCHCE II) scores were recorded. RESULTS:Serum levels of galectin-3, S100B, and C-reactive protein were significantly elevated in the postpartum women than in the healthy women. Galectin-3 levels were highly associated with APCHCE II scores and S100B and C-reactive protein levels. Galectin-3, C-reactive protein, and S100B levels and APCHCE II scores were identified as independent predictors for delirium. Area under the curve (AUC) of serum galectin-3 levels was similar to that of S100B levels, and significantly exceeded those of C-reactive protein levels and APCHCE II scores. Moreover, galectin-3 significantly improved the AUCs of APCHCE II scores, S100B levels, and C-reactive protein levels. CONCLUSIONS:Galectin-3, involved in inflammatory process underlying delirium-related brain injury, might be a potential biomarker to predict delirium of postpartum ICU women.

SUBMITTER: Zhu Y

PROVIDER: S-EPMC5561326 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

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Serum galectin-3 levels and delirium among postpartum intensive care unit women.

Zhu Ying Y Hu Wei W Zhu Ming-Li ML Yin Ting T Su Jun J Wang Jian-Rong JR

Brain and behavior 20170721 8

<h4>Objective</h4>Inflammation correlates with delirium. Galectin-3 is a proinflammatory protein. This study aimed to determine relation of serum galectin-3 levels to delirium of postpartum intensive care unit (ICU) women.<h4>Materials and methods</h4>In this prospective observational study, serum galectin-3, S100B, and C-reactive protein levels of 412 postpartum ICU women and 412 healthy women were measured. Delirium and Acute Physiology and Chronic Health Care Evaluation II (APCHCE II) scores ...[more]

PMID: 28828226

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Project description:BACKGROUND:Accurate prediction of delirium in the intensive care unit (ICU) may facilitate efficient use of early preventive strategies and stratification of ICU patients by delirium risk in clinical research, but the optimal delirium prediction model to use is unclear. We compared the predictive performance and user convenience of the prediction model for delirium (PRE-DELIRIC) and early prediction model for delirium (E-PRE-DELIRIC) in ICU patients and determined the value of a two-stage calculation. METHODS:This 7-country, 11-hospital, prospective cohort study evaluated consecutive adults admitted to the ICU who could be reliably assessed for delirium using the Confusion Assessment Method-ICU or the Intensive Care Delirium Screening Checklist. The predictive performance of the models was measured using the area under the receiver operating characteristic curve. Calibration was assessed graphically. A physician questionnaire evaluated user convenience. For the two-stage calculation we used E-PRE-DELIRIC immediately after ICU admission and updated the prediction using PRE-DELIRIC after 24 h. RESULTS:In total 2178 patients were included. The area under the receiver operating characteristic curve was significantly greater for PRE-DELIRIC (0.74 (95% confidence interval 0.71-0.76)) compared to E-PRE-DELIRIC (0.68 (95% confidence interval 0.66-0.71)) (z score of -?2.73 (p?<?0.01)). Both models were well-calibrated. The sensitivity improved when using the two-stage calculation in low-risk patients. Compared to PRE-DELIRIC, ICU physicians (n?=?68) rated the E-PRE-DELIRIC model more feasible. CONCLUSIONS:While both ICU delirium prediction models have moderate-to-good performance, the PRE-DELIRIC model predicts delirium better. However, ICU physicians rated the user convenience of E-PRE-DELIRIC superior to PRE-DELIRIC. In low-risk patients the delirium prediction further improves after an update with the PRE-DELIRIC model after 24 h. TRIAL REGISTRATION:ClinicalTrials.gov, NCT02518646 . Registered on 21 July 2015.

Project description:BackgroundPatients in the intensive care unit (ICU) are known to be at increased risk of developing delirium, but the risk of subsequent neuropsychiatric disorders is unclear. We therefore sought to examine the association between the presence of delirium in the ICU and incident neuropsychiatric disorders (including depressive, anxiety, trauma-and-stressor-related, and neurocognitive disorders) post-ICU stay among adult medical-surgical ICU patients.MethodsRetrospective cohort study utilizing clinical and administrative data from both inpatient and outpatient healthcare visits to identify the ICU cohort and diagnostic information 5 years prior to and 1 year post-ICU stay. Patients ≥ 18 years of age admitted to one of 14 medical-surgical ICUs across Alberta, Canada, January 1, 2014-June 30, 2016, and survived to hospital discharge were included. The main outcome of interest was a new diagnosis of any neuropsychiatric disorder 1 year post-ICU stay. The exposure variable was delirium during the ICU stay identified through any positive delirium screen by the Intensive Care Unit Delirium Screening Checklist (ICDSC) during the ICU stay.ResultsOf 16,005 unique patients with at least one ICU admission, 4033 patients were included in the study of which 1792 (44%) experienced delirium during their ICU stay. The overall cumulative incidence of any neuropsychiatric disorder during the subsequent year was 19.7% for ICU patients. After adjusting for hospital characteristics using log-binomial regression, patients with delirium during the ICU stay had a risk ratio (RR) of 1.14 (95% confidence interval [CI] 0.98-1.33) of developing any neuropsychiatric disorder within 1 year post-ICU compared to those who did not experience delirium. Delirium was significantly associated with neurocognitive disorders (RR 1.59, 95% CI 1.08-2.35), but not depressive disorders (RR 1.16, 95% CI 0.92-1.45), anxiety (RR 1.16, 95% CI 0.92-1.47), and trauma-and-stressor-related (RR 0.82, 95% CI 0.53-1.28) disorders.ConclusionsThe diagnosis of new onset of neurocognitive disorders is associated with ICU-acquired delirium. In this study, significant associations were not observed for depressive, anxiety, and trauma-and-stressor-related disorders.

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Serum galectin-3 levels and delirium among postpartum intensive care unit women.

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Serum galectin-3 levels and delirium among postpartum intensive care unit women.

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