Biomarkers to detect perioperative brain injury

Project Leader: Dr Matthew Luney, Academic Clinical Fellow

Almost half of all operations are performed for people aged over 60 years. In this patient group, around 1 in 8 will develop postoperative delirium, which is associated with PTSD, increased hospitalization, institutional care and up to double the mortality risk.

Just as an electrocardiogram (ECG) is essential in ischaemic heart disease or blood glucose testing in diabetes, so too we need to reliably monitor the brain in people at risk of delirium. Matthew’s main research project aims to improve our understanding of delirium risk after surgery and our ability to identify who will develop delirium. It is a feasibility study of the use of blood biomarkers and neurophysiologic measurements in the prediction of:

• postoperative delirium and its severity, and
• longer-term postoperative cognitive dysfunction.

The study's findings hold the potential to target interventions to reduce postoperative delirium.

The project is based in the Nuffield Department of Anaesthetics, Nuffield Division of Clinical Neurosciences (NDCN), with supervision from Dr Martyn Ezra, Honorary Clinical Lecturer. Matthew and his colleagues are also developing collaborations with the Kennedy Institute (Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences - NDORMS), who have expertise in inflammatory biomarker analysis.

Matthew’s other research interest during the ACF involves:

• the development of risk prediction models for postoperative complications, and
• epidemiologic analysis of the time-dependent nature of perioperative risk in those with cardiovascular and cerebrovascular disease.

Through this work, Matthew has collaborated with the Academic Unit of Injury, Recovery and Inflammation Sciences (University of Nottingham).

January 2023