The possible interaction between tryptophan and its metabolites with delirium in older patients with critical illnesses


Kollu K., Kurku H., Unlu A., Ecer B., GÜNEY İ., KIZILARSLANOĞLU M. C.

European Geriatric Medicine, cilt.15, sa.6, ss.1937-1948, 2024 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 15 Sayı: 6
  • Basım Tarihi: 2024
  • Doi Numarası: 10.1007/s41999-024-01114-7
  • Dergi Adı: European Geriatric Medicine
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.1937-1948
  • Anahtar Kelimeler: Delirium, Intensive care unit, Kynurenine pathway, Tryptophan, Older patient
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Aim: To investigate the relationship between delirium and tryptophan and its metabolites in critically ill older patients. Findings: The level of TRP was significantly (borderline) decreased among patients with delirium (p = 0.056). The KYN/TRP and QA/TRP ratios were statistically and significantly higher in patients with delirium than those without (p < 0.001 and p = 0.016, respectively). The best predictive values for detecting delirium were calculated as ≤14,100 ng/mL for TRP (AUC: 0.601, p = 0.052), >1.12 for KYN/TRP ratio (AUC: 0.704, p < 0.001), and > 0.75 for QA/TRP ratio (AUC: 0.627, p = 0.013). The QA/TRP ratio showed independent and borderline significant association with being delirium in multivariable regression analysis (Odds ratio: 2.007, p = 0.066). Message: This study demonstrated that tryptophan and its metabolites obtained within the first 24 h of ICU admission might have predictive value for determining high-risk older patients for delirium.