ABSTRACT
Objective:
To evaluate the relationship between preoperative
SARS-CoV-2 vaccination and
postoperative delirium(POD) in the
patients.
Methods:
A total of 938 participants of either
sex,
aged 50-90 yr, weighing 50-90 kg, of American Society of
Anesthesiologists Physical Status
classificationⅠorⅡ, with preoperative Mini-Mental
State Examination score ≥24, without
communication barriers, undergoing elective
knee or
hip joint replacement under combined spinal-
epidural anesthesia from June 2020 to June 2022 in Qingdao
Municipal Hospital, were enrolled. The
vaccination with
SARS-CoV-2 inactivated vaccine within 6 months before operation was recorded. The
cerebrospinal fluid 2 ml was extracted after the
puncture needle was successfully inserted into the
subarachnoid space for
determination of the concentrations of Aβ42, total
tau protein (t-tau), and phosphorylated
tau protein (p-tau) by
enzyme-linked immunosorbent assay (by
enzyme-linked immunosorbent assay). The Aβ42/t-tau and Aβ42/p-tau ratios were calculated. POD was assessed using the
Confusion Assessment
Method twice a day within 7 days after
surgery or before discharge.The
patients were divided into POD group and non-POD group according to whether they developed POD. The
risk factors of which P values were less than 0.20 in the univariate
logistic regression would enter the multivariate
logistic regression analysis to investigate the relationship between SARS-CoV-2 vaccine and level of cerebral spinal fluid (CSF)
biomarkers and POD.
Results:
Eight hundred and seventy-four
patients were finally enrolled in the
analysis, of which 169
patients developed POD, with an
incidence of 19.3%.The results of
logistic regression showed that
vaccination with
SARS-CoV-2 inactivated vaccine within 6 months before operation, preoperative concentrations of Aβ42 in CSF, and increase in Aβ42/t-tau and Aβ42/p-tau ratios were
protective factors for POD, and preoperative elevated concentrations of t-tau and p-tau in CSF were
risk factors for POD ( P<0.05). After
gender, age, preoperative Mini-Mental
State Examination score, years of
education,
history of
drinking,
hypertension,
diabetes mellitus and
coronary heart disease were added to eliminate the influence of confounding factors, the results still showed that
vaccination with
SARS-CoV-2 inactivated vaccine within 6 months before operation was a
protective factor for POD.
Conclusions:
Vaccination with
SARS-CoV-2 inactivated vaccine within 6 months before operation is a
protective factor for POD in
patients.