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ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Aging Psychiatry
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1522984
This article is part of the Research Topic Post-Operative Neuropsychiatric Disorders, volume II View all articles
Circulating tsRNAs serve as potential biomarkers for predicting postoperative delirium in elderly patients receiving lower extremity orthopedic surgery
Provisionally accepted- 1 Department of Anesthesia, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, China
- 2 Ningbo University, Ningbo, Zhejiang Province, China
- 3 Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, Hubei Province, China
- 4 Jinhua Maternity and Child Health Care Hospital, Jinhua, Zhejiang Province, China
Background: Postoperative delirium (POD) is a serious neuropsychiatric complication in elderly surgical patients, yet its pathogenesis remains incompletely understood.Transfer RNA-derived small RNAs (tsRNAs) have emerged as crucial regulators in neurological disorders. We investigated whether specific tsRNAs could serve as predictive biomarkers for POD.Methods:This study conducted a prospective case-control study of 158 elderly patients (≥60 years) undergoing orthopedic surgery.Plasma samples were collected preoperatively and on postoperative day 3.tsRNA expression profiles were analyzed using RNA sequencing and validated by RT-qPCR. Propensity score matching was performed to balance demographic and clinical variables.The predictive value of candidate tsRNAs was assessed using ROC analysis, and their potential functions were explored through bioinformatic analyses.Results:Among 128 non-POD and 30 POD patients, two tsRNAs (Other-14: 31-tRNA-Gly-CCC-3 and Other-39: 73-tRNA-Arg-TCG-5) showed significantly elevated preoperative levels in POD patients (p<0.001).ROC analysis revealed strong predictive performance (AUC=0.868 and 0.956, respectively).These differences persisted in the propensity-matched cohort (29 pairs).Bioinformatic analyses indicated enrichment in pathways related to neurotransmission, inflammation, and metabolism.Conclusion: This study identified novel tsRNA biomarkers that robustly predict POD risk and provide insights into its molecular pathogenesis.These findings may facilitate early risk stratification and preventive interventions.
Keywords: tsRNA, Postoperative delirium(POD), RT-qPCR, elderly patients, Propensity score matching(PSM)
Received: 14 Nov 2024; Accepted: 24 Feb 2025.
Copyright: © 2025 Cao, Zhao, Chen, Wu, Huang and Zhu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Changshun Huang, Department of Anesthesia, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, China
Binbin Zhu, Department of Anesthesia, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, China
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