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. 2019 Nov 6:11:752-762.
doi: 10.1016/j.dadm.2019.09.004. eCollection 2019 Dec.

The Role of Inflammation after Surgery for Elders (RISE) study: Study design, procedures, and cohort profile

Tammy T Hshieh  1   2   3 , Sarinnapha M Vasunilashorn  2   3   4 , Madeline L D'Aquila  2 , Steven E Arnold  3   5 , Bradford C Dickerson  3   5 , Tamara G Fong  2   3   6 , Richard N Jones  7   8 , Edward R Marcantonio  2   3   4 , Eva M Schmitt  2   3 , Guoquan Xu  2   3 , Yun Gou  2 , Fan Chen  2 , Lisa J Kunze  3   9 , Kamen V Vlassakov  3   10 , Ayesha R Abdeen  3   11 , Jeffrey K Lange  3   12 , Brandon E Earp  3   13 , Alexandra Touroutoglou  3   5 , Becky C Carlyle  3   5 , Pia Kivisakk-Webb  5 , Thomas G Travison  2   3 , Simon T Dillon  3   4 , Towia A Libermann  3   14 , Sharon K Inouye  2   3   4 ; RISE Study Group
Collaborators, Affiliations

The Role of Inflammation after Surgery for Elders (RISE) study: Study design, procedures, and cohort profile

Tammy T Hshieh et al. Alzheimers Dement (Amst). .

Abstract

Introduction: The Role of Inflammation after Surgery for Elders study correlates novel inflammatory markers measured in blood, cerebrospinal fluid (CSF) assays, and [11C]-PBR28 positron-emission tomography imaging.

Methods: This study involved a prospective cohort design with patients who underwent elective hip and knee arthroplasty under spinal anesthesia. Sixty-five adults participated with their family members. Inflammatory biomarker assays were measured preoperatively on day 1 and postoperatively at one month.

Results: On average, participants were 75 years old, and 72% were female. 54% underwent total knee arthroplasty, and 46% underwent total hip arthroplasty. The mean Modified Mini-Mental State (3MS) Examination score was 89.3; four patients (6%) scored ≤77 points. Plasma assays were completed in 63 (97%) participants, cerebrospinal fluid assays in 61 (94%), and PET imaging in 44 (68%).

Discussion: This complex study presents an innovative effort to correlate peripheral and central inflammatory biomarkers before and after major surgery in older adults. Strengths include collecting concurrent blood, cerebrospinal fluid, and positron-emission tomography with detailed clinical characterization of delirium, cognition, and functional status.

Keywords: Biomarkers; Cerebrospinal fluid; Delirium; Inflammation; Methods; Plasma; Positron emission tomography; Surgery.

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Figures

Fig. 1
Fig. 1
Hypothesized inflammatory pathway in delirium. Abbreviations: CSF, cerebrospinal fluid; PET, positron emission tomography.
Fig. 2
Fig. 2
Enrollment flow into the RISE study (Consort Diagram). Abbreviations: RISE, Role of Inflammation after Surgery in Elders; [11C]-PBR28 PET, positron emission tomography; SNP, single nuclear polymorphism; CSF, cerebrospinal fluid. *At baseline and/or one-month.
Fig. 3
Fig. 3
Patient contributions of plasma, cerebrospinal fluid, and [11C]-PBR28 PET imaging. A total of 65 patients were enrolled in the RISE study. Overall, 24 patients completed all 3 biomarker procedures at both time points (preoperatively and one month postoperatively). Owing to logistic constraints, some patients could not complete all study components. The distributions of biomarkers completed are detailed in this figure. Collection of plasma was completed in 63 (97%) patients. CSF assay was completed in 61 (94%) patients, with 56 at baseline and 40 at one month. [11C]-PBR28 PET imaging was competed in 44 (68%) patients, with 39 at baseline and 41 at follow-up. Abbreviation: [11C]-PBR28 PET, positron emission tomography.
See this image and copyright information in PMC

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