@techreport{oai:ipsj.ixsq.nii.ac.jp:00232777,
 author = {Tien, Hao Chen and Ryoichi, Sadahiro and Junichiro, Yoshimoto and Tien, Hao Chen and Ryoichi, Sadahiro and Junichiro, Yoshimoto},
 issue = {28},
 month = {Feb},
 note = {Objective: Postoperative delirium is a clinical syndrome characterized by acute disturbances in attention, cognition, and consciousness after surgery. While various hypotheses exist regarding its pathophysiology, such as abnormalities in neurotransmitters and inflammatory responses, none of them fails to explain heterogeneous symptoms of patients suffering from postoperative delirium. Aiming at a reasonable and objective stratification, we proposed a data-driven phenotyping classification based on the temporal progression of delirium symptoms. We then suggested that cancer surgery patients could be divided into seven subgroups [1]. In this study, we have investigated if physiological biomarkers involved in the neural and inflammatory systems are associated with the subgroups. Materials and Methods: We analyzed physiological data from 286 patients who underwent cancer resection surgery at the National Cancer Center, divided into seven subgroups in our previous study [1]. The data contains monoamines (dopamine, adrenaline, noradrenaline) and cytokines (IL-6, TGF-β1) sampled four consecutive days after the surgery. Using a generalized estimating equation, we then statistically tested if those physiological data were associated with the development of delirium and the subgroups. Results: The results showed a significant association between TGF-β1 and the subgroups. Also, IL-6 and dopamine showed a significant association with the development of delirium. Conclusion: The analysis was still exploratory, and we need a prospective study to validate the associations. Our preliminary results may pave the way for biological subtyping to contribute to precise medicine., Objective: Postoperative delirium is a clinical syndrome characterized by acute disturbances in attention, cognition, and consciousness after surgery. While various hypotheses exist regarding its pathophysiology, such as abnormalities in neurotransmitters and inflammatory responses, none of them fails to explain heterogeneous symptoms of patients suffering from postoperative delirium. Aiming at a reasonable and objective stratification, we proposed a data-driven phenotyping classification based on the temporal progression of delirium symptoms. We then suggested that cancer surgery patients could be divided into seven subgroups [1]. In this study, we have investigated if physiological biomarkers involved in the neural and inflammatory systems are associated with the subgroups. Materials and Methods: We analyzed physiological data from 286 patients who underwent cancer resection surgery at the National Cancer Center, divided into seven subgroups in our previous study [1]. The data contains monoamines (dopamine, adrenaline, noradrenaline) and cytokines (IL-6, TGF-β1) sampled four consecutive days after the surgery. Using a generalized estimating equation, we then statistically tested if those physiological data were associated with the development of delirium and the subgroups. Results: The results showed a significant association between TGF-β1 and the subgroups. Also, IL-6 and dopamine showed a significant association with the development of delirium. Conclusion: The analysis was still exploratory, and we need a prospective study to validate the associations. Our preliminary results may pave the way for biological subtyping to contribute to precise medicine.},
 title = {An exploratory study on physiological indicators for subtyping delirium},
 year = {2024}
}