CSF Beta-amyloid 1-42 Concentration Predicts Delirium Following Elective Arthroplasty Surgery in an Observational Cohort Study
Cunningham EL, McGuinness B, McAuley DF, Toombs J, Mawhinney T, O'Brien S, Beverland D, Schott JM et al.. Annals of surgery, 2019-06-01
Topic: Brain proteins, microglia and lab models
Objective To test the hypothesis that APOE ε4 status and cerebrospinal fluid (CSF) Aβ42, T-tau and P-tau would independently predict the risk of postoperative delirium. Background Delirium following surgery is common and associated with adverse outcomes. Age and cognitive impairment are consistent risk factors for postoperative delirium. Methods This observational cohort study recruited 282 participants aged 65 years or older, without a diagnosis of dementia, admitted for primary elective hip or knee arthroplasty. Cognitive tests were undertaken preoperatively, blood and CSF were sampled at the time of spinal anesthesia, and participants were assessed daily postoperatively for delirium. Results Increasing age (P = 0.04), preoperative comorbidity (P = 0.03), type of surgery (P = 0.05), intravenous opioid usage (P = 0.04), and low CSF Aβ42 (P Conclusions This study is the first to show an independent association between CSF Aβ42 and delirium incidence in an elective surgical population, suggesting that postoperative delirium may indicate incipient Alzheimer disease.
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APA 7th
Cunningham, E. L., McGuinness, B., McAuley, D. F., Toombs, J., Mawhinney, T., O'Brien, S., et al. (2019). CSF Beta-amyloid 1-42 Concentration Predicts Delirium Following Elective Arthroplasty Surgery in an Observational Cohort Study. Annals of surgery. https://doi.org/10.1097/sla.0000000000002684
Vancouver
Cunningham EL, McGuinness B, McAuley DF, Toombs J, Mawhinney T, O'Brien S, et al. CSF Beta-amyloid 1-42 Concentration Predicts Delirium Following Elective Arthroplasty Surgery in an Observational Cohort Study. Annals of surgery. 2019. doi:10.1097/sla.0000000000002684. PMID: 31082921.
BibTeX
@article{cunningham2019-31082921,
author = {Cunningham, E. L. and McGuinness, B. and McAuley, D. F. and Toombs, J. and Mawhinney, T. and O'Brien, S. and Beverland, D. and Schott, J. M. and others},
title = {{CSF Beta-amyloid 1-42 Concentration Predicts Delirium Following Elective Arthroplasty Surgery in an Observational Cohort Study}},
journal = {Annals of surgery},
year = {2019},
doi = {10.1097/sla.0000000000002684},
pmid = {31082921},
url = {https://doi.org/10.1097/sla.0000000000002684}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
Key findings
- Background Delirium following surgery is common and associated with adverse outcomes.
- Results Increasing age (P = 0.04), preoperative comorbidity (P = 0.03), type of surgery (P = 0.05), intravenous opioid usage (P = 0.04), and low CSF Aβ42 (P < 0.01) were independent predictors of postoperative delirium.
Why it matters
In this cohort of older adults having elective hip or knee surgery, low cerebrospinal fluid beta-amyloid 1-42 was independently associated with postoperative delirium. The authors suggest delirium after surgery may be an early sign of Alzheimer disease, but this does not show any way to treat or prevent it.
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Study details
- Study designcohort study
- Participants282
- Evidence strengthModerate
How this study scored 59/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Annals of surgery) |
| Journal's citation record | 3 / 4 | Annals of Surgery: journal h-index 453 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2019 — within 10 year(s) of the newest study here |
| Sample size | 2 / 4 | 282 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 4 / 7 | Cited 97 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 10.8 citations a year over 9 year(s) since 2019 |
| Impact for its field and year | 3 / 6 | Cited 5.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 5 other studies in this library |
| Still being cited | 2 / 4 | Cited 37 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Anthony Peter Passmore: h-index 38 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University College London: institution h-index 2,029 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 6 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 31082921) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 59 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1097/sla.0000000000002684
- PubMed: 31082921
- Original source →
- Free full text: pureadmin.qub.ac.uk →
Full text: free to read — Unpaywall lists this copy as free to read: the link above (checked 10 Oct 2026).
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