Objective To examine the association of the plasma neuroaxonal injury markers neurofilament light (NfL), total tau, glial fibrillary acid protein, and ubiquitin carboxyl‐terminal hydrolase L1 with delirium, delirium severity, and cognitive performance. Methods Delirium case–no delirium control (n = 108) pairs were matched by age, sex, surgery type, cognition, and vascular comorbidities. Biomarkers were measured in plasma collected preoperatively (PREOP), and 2 days (POD2) and 30 days postoperatively (PO1MO) using Simoa technology (Quanterix, Lexington, MA). The Confusion Assessment Method (CAM) and CAM‐S (Severity) were used to measure delirium and delirium severity, respectively. Cognitive function was measured with General Cognitive Performance (GCP) scores. Results Delirium cases had higher NfL on POD2 and PO1MO (median matched pair difference = 16.2pg/ml and 13.6pg/ml, respectively; p &lt; 0.05). Patients with PREOP and POD2 NfL in the highest quartile (Q4) had increased risk for incident delirium (adjusted odds ratio [OR] = 3.7 [95% confidence interval (CI) = 1.1–12.6] and 4.6 [95% CI = 1.2–18.2], respectively) and experienced more severe delirium, with sum CAM‐S scores 7.8 points (95% CI = 1.6–14.0) and 9.3 points higher (95% CI = 3.2–15.5). At PO1MO, delirium cases had continued high NfL (adjusted OR = 9.7, 95% CI = 2.3–41.4), and those with Q4 NfL values showed a −2.3 point decline in GCP score (−2.3 points, 95% CI = −4.7 to −0.9). Interpretation Patients with the highest PREOP or POD2 NfL levels were more likely to develop delirium. Elevated NfL at PO1MO was associated with delirium and greater cognitive decline. These findings suggest NfL may be useful as a predictive biomarker for delirium risk and long‐term cognitive decline, and once confirmed would provide pathophysiological evidence for neuroaxonal injury following delirium. ANN NEUROL 2020;88:984–994

Tamara G. Fong

Sarinnapha M. Vasunilashorn

Long Ngo

Towia A. Libermann

Simon T. Dillon

Eva M. Schmitt

Alvaro Pascual‐Leone

Steven E. Arnold

Richard N. Jones

Edward R. Marcantonio

Sharon K. Inouye

Annals of Neurology

《神经病学年鉴》发表了对神经病学具有广泛兴趣的文章，尤其是那些对理解人类神经系统疾病的机制和治疗有重大影响的文章。尽管 ANNALS 使用多种临床和基本神经科学方法发表论文，但我们最感兴趣的是学术神经学家普遍感兴趣的那些手稿，包括临床试验和其他为医学实践提供信息的大规模研究。纯粹的基础研究，没有很强的临床或转化潜力，不太可能有足够的优先发表权。

The Annals of Neurology publishes articles on a wide range of topics relevant to neurology, particularly those that have a significant impact on understanding the mechanisms and treatments of human neurological diseases. While the Annals employs various clinical and basic neuroscience methods for publication, we are particularly interested in manuscripts that are of general interest to academic neurologists, including clinical trials and large-scale studies that provide valuable information for medical practice. Purely basic research, lacking strong clinical or translational potential, is less likely to receive priority for publication.

《Annals of Neurology》发表了与神经病学相关的广泛主题文章，特别是那些对理解人类神经系统疾病的机制和治疗具有重要影响的研究。虽然《Annals of Neurology》采用多种临床和基础神经科学方法来发表论文，但我们特别关注那些学术神经学家普遍感兴趣的稿件，包括临床试验和其他为医学实践提供重要信息的大规模研究。纯粹的基础研究，若缺乏明显的临床或转化潜力，通常不具备优先发表的条件。

Ann Neurol

Association of Plasma Neurofilament Light with Postoperative Delirium

The association of the plasma neuroaxonal injury markers neurofilament light, total tau, glial fibrillary acid protein, and ubiquitin carboxyl‐terminal hydrolase L1 withdelirium, delirium severity, and cognitive performance is examined.

Category	Quartile
医学	1
医学, 临床神经病学	1
医学, 神经科学	1

Association of Plasma Neurofilament Light with Postoperative Delirium

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