Influence of Apelin Levels on Postoperative Cognitive Disorders After Orthopedic Surgery in Elderlies
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 88
- 试验地点
- 1
- 主要终点
- Postoperative delirium occurrence.
研究概览
简要总结
No successful strategy is proposed to patients submitted to important surgery to reduce the incidence of postoperative cognitive disorders (POCD) onset. This project propose to measure plasma levels of apelin in wide population submitted to orthopedic surgery. Apelin could be involved in anti-inflammatory processes. Apelin levels before and after surgery correlated to postoperative cognitive disorders symptom measured by PET-Scan could be an important predictive or diagnostic marker to adapt therapeutic strategy to fight against postoperative cognitive disorders.
详细描述
It has been now clearly shown that important surgery with general anesthesia could be strongly associated to postoperative cognitive disorders few months after the intervention especially in elderlies. No strategy is really efficient to fight against this phenomenon that could lead to Alzheimer disease development. In order to prognosticate and characterize the potential risk to develop cognitive troubles after a surgery, this study propose to evaluate the potential predictive capacity of apelin in a cohort of young and old adult undergoing an orthopedic surgery. Apelin is a peptide involved in different physiological as well physiopathological pathways. This peptide, involved in osteogenesis and inflammatory processes, has also been described to be neuroprotective. Yet, hippocampic neuroinflammation has been related in case of postoperative cognitive disorders in human as well as in mice model of surgery. Taken together, these results seem to indicate that apelin could be a therapeutic target and be predictive of the postoperative cognitive disorders onset.
This study will measure plasma apelin levels in young and old adult one day before and after a programed orthopedic surgery. Moreover, to correlate apelin amounts with inflammation processes, protocol will quantify inflammatory cytokines in plasma (IL6, IL1, TNFα). These results will be compared to measures of brain b-amyloid deposit assessed by PET-Scan technology.
The follow-up of the patients will be done during 3 months in order to evaluate the postoperative cognitive disorders or the cognitive troubles associated to surgery (memory fail, decrease of cognitive reserve...).
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Diagnostic
- 盲法
- None
入排标准
- 年龄范围
- 75 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients submitted to a programed orthopedic surgery
- •Patients with pre- and post-surgery check-up.
排除标准
- •Non programed orthopedic surgery (emergency)
- •Patients with sepsis
- •Patients submitted to orthopedic surgery but with ambulatory management.
- •Existence of justice backup, curators or supervision.
- •Absence of indication for a pre- or post-surgery check-up.
结局指标
主要结局
Postoperative delirium occurrence.
时间窗: day1 to day 7 post-operation
Evaluation of the occurrence of postoperative delirium evaluated by the Confusion Assessment Method (CAM)
次要结局
- Concentration of inflammatory cytokines and apelin in the cerebrospinal fluid.(day 0 (operation day))
- Assessment of the autonomy.(day 1 to day 7 and 3 month after post-operation)
- Evaluation of postoperative cognitive functions.(day 1 to day 7 and 3 month after post-operation)
- Plasma concentration of apelin.(day 1 to day 7 post operation)
- Plasma concentration of inflammatory cytokines.(24 hours before operation, day 1 to day 7 post operation)