{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:41:10Z","timestamp":1786650070660,"version":"build-2736575974"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Postoperative delirium is described as one of the most common complications for elderly patients with unknown pathophysiological pathways. In this present study, we analyzed the clinical and biochemical parameters in elderly patients with or without a delirium after open abdominal surgery to investigate the possible predicative factors for a delirium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>Patients aged \u226560 years scheduled to undergo elective gastrointestinal tumor resection via laparotomy from July 2012 to June 2015 were enrolled in this study. Demographic and clinical data, characteristics of the surgical and anesthetic procedure, biochemical parameters were compared between patients with or without a delirium. Multivariate logistic regression testing was used for the evaluation of independent risk factors for postoperative delirium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Overall, 112 participants were enrolled in this study, 49 of which were diagnosed with postoperative delirium. Patients with a delirium had an older age (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.013) and a lower Mini-Mental State Examination (MMSE) score (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01) compared with those patients who had no delirium. The duration of surgery and anesthesia, the levels of neopterin, C-reactive protein, interleukin-6, insulin-like growth factor-1 in patients with a delirium were significantly higher than those without a delirium (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). Independent risk factors in the logistic regression for postoperative delirium were the levels of neopterin and MMSE scores.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Our present study suggested the potential roles of neopterin and MMSE scores in the pathophysiology and prediction of delirium in elderly patients after open abdominal surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/0973-1482.192764","type":"journal-article","created":{"date-parts":[[2018,7,19]],"date-time":"2018-07-19T09:03:38Z","timestamp":1531991018000},"page":"1234-1238","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":25,"title":["Neopterin and mini-mental state examination scores, two independent risk factors for postoperative delirium in elderly patients with open abdominal surgery"],"prefix":"10.4103","volume":"14","author":[{"given":"Suqin","family":"Miao","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peipei","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huijuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinchun","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dezhen","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,11,28]]},"reference":[{"key":"R1-20260109","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1111\/j.1532-5415.2000.tb04698.x","article-title":"Predicting adverse postoperative outcomes in patients aged 80 years or older","volume":"48","author":"Liu","year":"2000","journal-title":"J Am Geriatr Soc"},{"key":"R2-20260109","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1056\/NEJMra052321","article-title":"Delirium in older persons","volume":"354","author":"Inouye","year":"2006","journal-title":"N Engl J Med"},{"key":"R3-20260109","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1002\/bjs.6843","article-title":"Risk factors and incidence of postoperative delirium in elderly patients after elective and emergency surgery","volume":"97","author":"Ansaloni","year":"2010","journal-title":"Br J Surg"},{"key":"R4-20260109","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.ejcnurse.2010.09.001","article-title":"Risk factors of delirium after cardiac surgery: A systematic review","volume":"10","author":"Koster","year":"2011","journal-title":"Eur J Cardiovasc Nurs"},{"key":"R5-20260109","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.bandc.2010.05.010","article-title":"Cortisol, interleukins and S100B in delirium in the elderly","volume":"74","author":"van Munster","year":"2010","journal-title":"Brain Cogn"},{"key":"R6-20260109","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1016\/j.genhosppsych.2006.06.002","article-title":"The role of oxidative stress in postoperative delirium","volume":"28","author":"Karlidag","year":"2006","journal-title":"Gen Hosp Psychiatry"},{"key":"R7-20260109","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/j.jpsychores.2006.11.013","article-title":"Cytokines and acute phase response in delirium","volume":"62","author":"de Rooij","year":"2007","journal-title":"J Psychosom Res"},{"key":"R8-20260109","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1046\/j.1365-2710.2001.00358.x","article-title":"Neopterin measurement in clinical diagnosis","volume":"26","author":"Berdowska","year":"2001","journal-title":"J Clin Pharm Ther"},{"key":"R9-20260109","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1093\/eurheartj\/ehi111","article-title":"Elevated serum neopterin predicts future adverse cardiac events in patients with chronic stable angina pectoris","volume":"26","author":"Avanzas","year":"2005","journal-title":"Eur Heart J"},{"key":"R10-20260109","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1001\/jama.1994.03510260066030","article-title":"A clinical prediction rule for delirium after elective noncardiac surgery","volume":"271","author":"Marcantonio","year":"1994","journal-title":"JAMA"},{"key":"R11-20260109","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1056\/NEJMc1209366","article-title":"Cognitive trajectories after postoperative delirium","volume":"367","author":"Khadka","year":"2012","journal-title":"N Engl J Med"},{"key":"R12-20260109","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J Chronic Dis"},{"key":"R13-20260109","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/S0009-8981(02)00076-1","article-title":"Degradation of serum neopterin during daylight exposure","volume":"322","author":"Laich","year":"2002","journal-title":"Clin Chim Acta"},{"key":"R14-20260109","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/S0165-1781(03)00113-6","article-title":"Serum amino acids, biopterin and neopterin during long-term immunotherapy with interferon-alpha in high-risk melanoma patients","volume":"119","author":"Van Gool","year":"2003","journal-title":"Psychiatry Res"},{"issue":"Suppl 2","key":"R15-20260109","first-page":"S256","article-title":"Biomarkers for delirium \u2013 A review","volume":"59","author":"Khan","year":"2011","journal-title":"J Am Geriatr Soc"},{"key":"R16-20260109","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.jpsychores.2010.02.009","article-title":"Incidence and predictors of delirium after cardiac surgery: Results from the IPDACS study","volume":"69","author":"Kazmierski","year":"2010","journal-title":"J Psychosom Res"},{"key":"R17-20260109","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1111\/j.1532-5415.2011.03885.x","article-title":"High preoperative plasma neopterin predicts delirium after cardiac surgery in older adults","volume":"60","author":"Osse","year":"2012","journal-title":"J Am Geriatr Soc"},{"key":"R18-20260109","doi-asserted-by":"crossref","first-page":"175","DOI":"10.2174\/1389200024605082","article-title":"Neopterin as a marker for immune system activation","volume":"3","author":"Murr","year":"2002","journal-title":"Curr Drug Metab"},{"key":"R19-20260109","doi-asserted-by":"crossref","first-page":"2081","DOI":"10.1007\/s00134-010-2004-4","article-title":"Early postoperative delirium after open-heart cardiac surgery is associated with decreased bispectral EEG and increased cortisol and interleukin-6","volume":"36","author":"Plaschke","year":"2010","journal-title":"Intensive Care Med"},{"key":"R20-20260109","doi-asserted-by":"crossref","first-page":"2148","DOI":"10.1212\/WNL.0b013e3182752eef","article-title":"Insulin-like growth factors in the brain and their potential clinical implications","volume":"79","author":"Benarroch","year":"2012","journal-title":"Neurology"},{"key":"R21-20260109","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1203\/01.PDR.0000111482.43827.40","article-title":"Potential role of IGF-I in hypoxia tolerance using a rat hypoxic-ischemic model: Activation of hypoxia-inducible factor 1alpha","volume":"55","author":"Wang","year":"2004","journal-title":"Pediatr Res"},{"key":"R22-20260109","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.1213\/ANE.0b013e318211501b","article-title":"Cognitive and functional predictors and sequelae of postoperative delirium in elderly patients undergoing elective joint arthroplasty","volume":"112","author":"Jankowski","year":"2011","journal-title":"Anesth Analg"},{"key":"R23-20260109","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1097\/SLA.0b013e318281b01c","article-title":"Predisposing and precipitating factors of delirium after cardiac surgery: A prospective observational cohort study","volume":"257","author":"Guenther","year":"2013","journal-title":"Ann Surg"},{"key":"R24-20260109","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1093\/infdis\/174.2.294","article-title":"Predictive markers of AIDS dementia complex: CD4 cell count and cerebrospinal fluid concentrations of beta 2-microglobulin and neopterin","volume":"174","author":"Brew","year":"1996","journal-title":"J Infect Dis"},{"key":"R25-20260109","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1016\/S0171-2985(00)80104-7","article-title":"Inflammation marker 7,8-dihydroneopterin induces apoptosis of neurons and glial cells: A potential contribution to neurodegenerative processes","volume":"202","author":"Speth","year":"2000","journal-title":"Immunobiology"},{"key":"R26-20260109","doi-asserted-by":"crossref","first-page":"2167","DOI":"10.1016\/j.biocel.2007.01.004","article-title":"Molecules in focus: Indoleamine 2,3-dioxygenase","volume":"39","author":"King","year":"2007","journal-title":"Int J Biochem Cell Biol"},{"key":"R27-20260109","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1097\/CCM.0b013e318236f62d","article-title":"The association of the kynurenine pathway of tryptophan metabolism with acute brain dysfunction during critical illness*","volume":"40","author":"Adams Wilson","year":"2012","journal-title":"Crit Care Med"},{"key":"R28-20260109","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1001\/jama.2010.1013","article-title":"Delirium in elderly patients and the risk of postdischarge mortality, institutionalization, and dementia: A meta-analysis","volume":"304","author":"Witlox","year":"2010","journal-title":"JAMA"},{"key":"R29-20260109","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1002\/gps.2326","article-title":"Serum S100B in elderly patients with and without delirium","volume":"25","author":"van Munster","year":"2010","journal-title":"Int J Geriatr Psychiatry"},{"key":"R30-20260109","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/1471-2377-9-21","article-title":"Markers of cerebral damage during delirium in elderly patients with hip fracture","volume":"9","author":"van Munster","year":"2009","journal-title":"BMC Neurol"},{"key":"R31-20260109","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1016\/j.jpsychires.2006.02.001","article-title":"Cognitive deterioration in Alzheimer's disease is accompanied by increase of plasma neopterin","volume":"41","author":"Blasko","year":"2007","journal-title":"J Psychiatr Res"},{"key":"R32-20260109","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/S0165-5728(99)00226-X","article-title":"Increased plasma levels of interleukin-1, interleukin-6 and alpha-1-antichymotrypsin in patients with Alzheimer's disease: Peripheral inflammation or signals from the brain","volume":"103","author":"Licastro","year":"2000","journal-title":"J Neuroimmunol"}],"container-title":["Journal of Cancer Research and Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/01363817-201814060-00013","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:01:44Z","timestamp":1786647704000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01363817-201814060-00013"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10]]},"references-count":32,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.4103\/0973-1482.192764","relation":{},"ISSN":["0973-1482","1998-4138"],"issn-type":[{"value":"0973-1482","type":"print"},{"value":"1998-4138","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10]]}}}