Association of S100B Serum Level With Postoperative Cognitive Dysfunction (POCD) in Non-Cardiac Surgery: A Meta-Analysis Study.

Abstract

<h4>Background and aims</h4>Postoperative cognitive dysfunction (POCD) is defined as a persistent decline in cognitive performance after a surgical procedure, for which no cause can be identified. S100B is a calcium-binding protein present in many organs, including the brain. Serum levels have been suggested to be related to POCD. The purpose of this systematic review and meta-analysis is to assess the association between S100B serum levels and cognitive dysfunction after non-cardiac surgeries.<h4>Methods</h4>We conducted a systematic search using PubMed/Medline, Scopus, Web of Science, and Google Scholar databases to identify studies. Studies measuring pre- and post-operative serum S100B levels in patients undergoing non-cardiac surgeries have been included. A random effects model was applied to determine the association of the levels of S100B with POCD.<h4>Results</h4>Of 280 studies screened, 11 articles were eligible for further analysis. The pooled results for pre- and post-treatment outcomes showed no significant differences. The pooled odds ratios (OR) for POCD after non-cardiac surgeries were 1.77 (95% CI = 1.17-2.67). Subgroup analysis showed that noticeable differences among age (≥ 65 and < 65 years) and continent (Asia vs. Europe) groups. The higher OR observed in the ≥ 65 years' group (OR = 1.94; 95% CI = 0.98-3.84), and studies from Europe (OR = 1.85; 95% CI = 0.79-4.33).<h4>Conclusion</h4>Overall, current evidence shows that the serum level of S100B is associated with the occurrence of POCD. The S100B monitor may help in the early diagnosis of POCD and the development of preventive strategies.