Early Postoperative Serum Sirtuin 1 Predicts Postoperative Cognitive Dysfunction in Elderly Patients

Introduction: Postoperative cognitive dysfunction (POCD) is a common complication following cardiac surgery, particularly in elderly patients undergoing cardiopulmonary bypass (CPB). While Sirtuin 1 (SIRT1) has been implicated in the mitigation of POCD, its potential as a predictive biomarker for POCD remains unclear.

Methods: Patients undergoing CPB cardiac surgery were evaluated for POCD using the Montreal Cognitive Assessment. Based on the assessment results, patients were divided into two groups, with further stratification by key factors. The correlation between these risk factors and POCD incidence was analyzed. Odds ratios were calculated for six risk factors, and the receiver operating characteristic curve analysis was used to evaluate the predictive power of early postoperative serum SIRT1 levels for POCD.

Results: Six risk factors-including age, education level, CPB duration, aortic occlusion duration, anesthesia duration, and early postoperative serum SIRT1-were strongly associated with POCD incidence. Patients with POCD had decreased early postoperative serum SIRT1 levels. SIRT1 was found to be a significant predictor of POCD, with high sensitivity and specificity. Additionally, neuron-specific enolase and S100β levels were elevated in POCD patients and negatively correlated with early postoperative serum SIRT1 levels.

Conclusions: Early postoperative serum SIRT1 serves as an effective biomarker for predicting POCD, offering both high sensitivity and specificity, and could be used to anticipate the onset of clinical POCD.