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Activity of butyrylcholinesterase (BChE) has been discussed controversially regarding a possible role in its development. This study aimed to investigate the relevance of BChE activity as a biomarker for postoperative delirium after cardiac surgery or percutaneous valve replacement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 237 patients who received elective cardiothoracic surgery or percutaneous valve replacement at a tertiary care centre were admitted preoperatively. These patients were tested with the Montreal Cognitive Assessment investigating cognitive deficits, and assessed for postoperative delirium twice daily for three days via the 3D-CAM or the CAM-ICU, depending on their level of consciousness. BChE activity was measured at three defined time points before and after surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Postoperative delirium occurred in 39.7% of patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200994). Univariate analysis showed an association of pre- and postoperative BChE activity with its occurrence (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). There was no association of postoperative delirium and the decline in BChE activity (pre- to postoperative,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.327). Multivariable analysis including either preoperative or postoperative BChE activity as well as age, MoCA, type 2 diabetes mellitus, coronary heart disease, type of surgery and intraoperative administration of red-cell concentrates was performed. Neither preoperative nor postoperative BChE activity was independently associated with the occurrence of postoperative delirium (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.086,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.484). Preoperative BChE activity was lower in older patients (B\u2009=\u2009-12.38 (95% CI: -21.94 to -2.83),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011), and in those with a history of stroke (B\u2009=\u2009-516.173 (95% CI: -893.927 to -138.420),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008) or alcohol abuse (B\u2009=\u2009-451.47 (95% CI: -868.38 to -34.55),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034). Lower postoperative BChE activity was independently associated with longer procedures (B\u2009=\u2009-461.90 (95% CI: -166.34 to -757.46),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), use of cardiopulmonary bypass (B\u2009=\u2009-262.04 (95% CI: -485.68 to -38.39),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022), the number of administered red cell-concentrates (B\u2009=\u2009-40.99 (95% CI: -67.86 to -14.12),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) and older age (B\u2009=\u2009-9.35 (95% CI: -16.04 to -2.66),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>BChE activity is not independently associated with the occurrence of postoperative delirium. Preoperative BChE values are related to patients\u2019 morbidity and vulnerability, while postoperative activities reflect the severity, length and complications of surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12883-024-03580-9","type":"journal-article","created":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T00:05:04Z","timestamp":1709251504000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Butyrylcholinesterase activity in patients with postoperative delirium after cardiothoracic surgery or percutaneous valve replacement- an observational interdisciplinary cohort study"],"prefix":"10.1186","volume":"24","author":[{"given":"Konstantin","family":"Schlake","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Teller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Hinken","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Laser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Lichtinghagen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Sch\u00e4fer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Fegbeutel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Weissenborn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolin","family":"Jung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Worthmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Magdalena","family":"Gabriel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,1]]},"reference":[{"issue":"1","key":"3580_CR1","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1111\/jgs.13281","volume":"63","author":"Anonymous American Geriatrics Society Abstracted Clinical Practice Guideline for Postoperative Delirium in Older Adults","year":"2015","unstructured":"Anonymous American Geriatrics Society Abstracted Clinical Practice Guideline for Postoperative Delirium in Older Adults. 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Anesth Analg. 2023. https:\/\/doi.org\/10.1213\/ANE.0000000000006246.","journal-title":"Anesth Analg"}],"container-title":["BMC Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-024-03580-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12883-024-03580-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-024-03580-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T00:05:31Z","timestamp":1709251531000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcneurol.biomedcentral.com\/articles\/10.1186\/s12883-024-03580-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,1]]},"references-count":43,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["3580"],"URL":"https:\/\/doi.org\/10.1186\/s12883-024-03580-9","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-3416773\/v1","asserted-by":"object"}]},"ISSN":["1471-2377"],"issn-type":[{"value":"1471-2377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,1]]},"assertion":[{"value":"6 October 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 February 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 March 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All patients gave written informed consent. The study was approved by the local ethics committee on the 06.06.2018 (Ethics Committee of Hannover Medical School, Hannover, Germany, Approval No. 7876 BO S 2018 by Univ. Prof. Dr. med. Stefan Engeli) and conducted in accordance with their relevant guidelines and regulations. The study was conducted in accordance with the\u00a0Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Patients signed informed consent regarding publishing their data.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"80"}}