einstein (São Paulo). 28/mar/2025;23:eAO1244.
Neuron-specific enolase and Tau protein as biomarkers for sepsis-associated delirium: a cross-sectional pilot study
Agnes Araújo Sardinha , Maira Mello de , Juliana Bahia , Rebeca Souza da , Hermes Vieira , Luz Marina Gómez , Ian Ward Abdalla , Júlio Flávio Meirelles , Flávia Barreto , Thiago Junqueira , Lucas de Moraes , Matheus Menão , Heraldo Possolo de , Júlio Cesar Garcia
DOI: 10.31744/einstein_journal/2025AO1244
Highlights
■ Biomarkers of brain injury, such as neuron-specific enolase and Tau proteins, are higher in older patients with sepsis and delirium.
■ Diagnosing sepsis in patients with delirium can be challenging.
■ Early identification of sepsis is key to managing sepsisassociated delirium.
■ Diagnosing sepsis in patients with delirium can be challenging.
■ Early identification of sepsis is key to managing sepsisassociated delirium.
ABSTRACT
Objective:
Sepsis-associated delirium is a common cerebral manifestation in patients with sepsis, potentially caused by a combination of neuroinflammation and other neurophysiological disorders. This study investigated the expression of neuron-specific enolase and Tau protein as biomarkers in patients with sepsis-associated delirium. While neuron-specific enolase and Tau protein are known to be associated with brain injury, their diagnostic potential in patients with sepsis-associated delirium is not well understood.
Methods:
This cross-sectional pilot study evaluated plasma levels of neuron-specific enolase and Tau protein in patients with delirium and sepsis to explore their potential for identifying sepsis in patients admitted to the emergency department.
Results:
A total of 25 patients with delirium were analyzed, 56% of whom had sepsis. Patients with sepsis exhibited significantly higher neuron-specific enolase levels (2.7ng/mL [95%CI= 2.2-3.2] versus 1.3 ng/mL [95%CI= 0.8-2.5], p<0.003) and Tau protein levels (96.1pg/mL [95%CI= 77.0-111.3] versus 43.0pg/mL [95%CI= 31.2-84.5], p<0.003) compared to patients without sepsis. Neuron-specific enolase and Tau protein thresholds of >2.08ng/mL and >59.27pg/mL, respectively, demonstrated 90% specificity for identifying sepsis in patients.
Conclusion:
Neuron-specific enolase and Tau protein levels were significantly higher in patients with sepsis than in those without, underscoring their potential ability to identify the infectious etiology of delirium in older patients admitted to emergency departments.
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Neuron-specific enolase and Tau protein as biomarkers for sepsis-associated delirium: a cross-sectional pilot study
Palavras-chave: Biomarkers; Delirium; Emergency medicine; Neuroinflammatory diseases; Sepsis
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