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

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

doi:10.1016/j.dadm.2019.09.004

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

Alzheimers Dement (Amst). 2019 Nov 6:11:752-762. doi: 10.1016/j.dadm.2019.09.004. eCollection 2019 Dec.

Authors

Tammy T Hshieh^{1

2

3}, Sarinnapha M Vasunilashorn^{2

3

4}, Madeline L D'Aquila², 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 Gou², Fan Chen², 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-Webb⁵, 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

RISE Study Group:
Sharon K Inouye, Steven Arnold, Bradford Dickerson, Tamara Fong, Richard Jones, Towia A Libermann, Edward R Marcantonio, Thomas Travison, Becky C Carlyle, Michele Cavallari, Simon T Dillon, Jacob Hooker, Tammy Hshieh, Savannah Kandigian, Pia Kivisakk-Webb, Long Ngo, Hasan Otu, Eva M Schmitt, Alexandra Touroutoglou, Bianca Trombetta, Sarinnapha Vasunilashorn, Ayesha Abdeen, Douglas Ayres, Brandon Earp, Jeffrey Lange, Gregory Brick, Antonia Chen, Robert Davis, Jacob Drew, Richard Iorio, Fulton Kornack, Michael Weaver, Anthony Webber, Richard Wilk, Lisa Kunze, David Shaff, Kamen Vlassakov, Brett Armstrong, Angelee Banda, Sylvie Bertrand, Madeline D'Aquila, Jacqueline Gallagher, Baileigh Hightower, Shannon Malloy, Jacqueline Nee, Chloe Nobuhara, Abigail Overstreet, Annie Racine, David Urick, Guoquan Xu, Grae Arabasz, Michael Brickhouse, Regan Butterfield, Shirley Hsu, Sara Makaretz, Judit Sore, Fan Chen, Yun Gou, Douglas Tommet, Sabrina Carretie, Ted Gruen, Katherine Tasker

Affiliations

¹ Division of Aging, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
² Aging Brain Center, Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA.
³ Harvard Medical School, Boston, MA, USA.
⁴ Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
⁵ Department of Neurology, Massachusetts Alzheimer's Disease Research Center, Massachusetts General Hospital, Boston, MA, USA.
⁶ Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
⁷ Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, RI, USA.
⁸ Department of Neurology, Brown University Warren Alpert Medical School, Providence, RI, USA.
⁹ Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
¹⁰ Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, USA.
¹¹ Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA.
¹² Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.
¹³ Department of Orthopedic Surgery, Brigham and Women's Faulkner Hospital, Boston, MA, USA.
¹⁴ Genomics, Proteomics, Bioinformatics and Systems Biology Center, Beth Israel Deaconess Medical Center, Boston, MA, USA.

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.

Abstract

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