{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T17:45:46Z","timestamp":1774633546516,"version":"3.50.1"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Postoperative delirium (POD) is a commonly occurring condition in the postoperative period. Therefore, the study intends to investigate the relationship between B<jats:sub>2<\/jats:sub>M and POD and the effect of B<jats:sub>2<\/jats:sub>M levels on three-year postoperative mortality in patients with POD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Postoperatively, the Confusion Assessment Method (CAM) and the Monumental Delirium Assessment Scale (MDAS) were used to assess the incidence and severity of POD. Preoperative plasma B<jats:sub>2<\/jats:sub>M levels were measured utilizing a latex-enhanced immunoturbidimetric assay. Total tau protein (T-tau), phosphorylated tau protein (P-tau), and amyloid \u03b2 plaque 42 (A\u03b2<jats:sub>42<\/jats:sub>) were detected in preoperative cerebrospinal fluid (CSF) by enzyme-linked immunosorbent assay. Logistic regression equations were applied to examine the risk factors linked to POD. Patients presenting with POD were grouped according to B<jats:sub>2<\/jats:sub>M level and followed up for 3 years postoperatively for their survival and Kaplan\u2013Meier survival curves were plotted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence of POD was 7.23%. Serum B<jats:sub>2<\/jats:sub>M levels were higher in POD patients compared to non-POD (NPOD) patients (<jats:italic>p<\/jats:italic>\u202f=\u202f0.01). The results of the logistic regression analysis indicated that B<jats:sub>2<\/jats:sub>M (<jats:italic>OR<\/jats:italic>\u202f=\u202f1.394, <jats:italic>95% CI<\/jats:italic>\u202f=\u202f1.017\u20131.910, <jats:italic>p<\/jats:italic>\u202f=\u202f0.002) and T-tau (<jats:italic>OR<\/jats:italic>\u202f=\u202f1.006, <jats:italic>95% CI<\/jats:italic>\u202f=\u202f1.002\u20131.011, <jats:italic>p\u202f=<\/jats:italic> 0.007) posed a risk for POD. B<jats:sub>2<\/jats:sub>M and POD were partially associated through the mediation of CSF T-tau (10.0%). The K-M survival curves showed that patients with high B<jats:sub>2<\/jats:sub>M who developed POD had a higher mortality rate 3 years after surgery (<jats:italic>p<\/jats:italic>\u202f=\u202f0.031).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In summary, B<jats:sub>2<\/jats:sub>M may be a risk factor for POD, which might be mediated in part by CSF T-tau.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1597764","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T05:25:07Z","timestamp":1754371507000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Correlation of \u03b22-microglobulin with postoperative delirium and 3-year mortality undergoing knee or hip replacement surgery: a prospective cohort 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