Cardiovascular

Serum C1q as a Novel Predictive Biomarker for Postoperative Delirium After Acute Type A Aortic Dissection.

Wang J, Jiang Y, et al. • Immunity, inflammation and disease • 2026

TL;DR

Serum C1q levels were significantly higher in patients who developed postoperative delirium after acute type A aortic dissection surgery, with preoperative C1q demonstrating predictive value (AUC = 0.788) for postoperative delirium occurrence.

Key Findings

Results

Serum C1q levels were significantly higher in patients who developed postoperative delirium compared to those who did not, both before and after surgery.

67 patients were prospectively enrolled in the study
C1q levels were measured preoperatively and on the first postoperative day
The difference was statistically significant at both time points
POD was assessed using the Confusion Assessment Method (CAM) or CAM-ICU for ICU patients

Results

Preoperative serum C1q levels were predictive of postoperative delirium on univariate logistic analysis.

OR = 1.379 (95% CI = 1.176–1.683, p < 0.001)
Analysis was performed using univariate logistic regression
Multivariate logistic regression was also employed to evaluate the association between C1q levels and POD
Pearson correlation coefficient was used as part of the statistical analyses

Results

Preoperative serum C1q demonstrated moderate discriminative ability for predicting postoperative delirium as measured by area under the ROC curve.

AUC for preoperative serum C1q was 0.788 (95% CI = 0.671–0.880)
This suggests reasonable predictive accuracy for a single biomarker in this clinical context
The study population consisted of 67 patients undergoing surgery for acute type A aortic dissection

Conclusions

C1q, a complement activation regulatory factor, was identified as a potential biomarker for predicting postoperative delirium in aortic dissection surgery patients.

The study design was prospective
C1q is described as a complement activation regulatory factor
Authors suggest C1q may be valuable for 'early diagnosis and intervention strategies for POD'
Both preoperative and first postoperative day measurements were evaluated

What This Means

This research suggests that a protein called C1q, which is part of the immune system's complement pathway, may help doctors predict which patients are likely to develop delirium after surgery for a serious heart condition called acute type A aortic dissection. The study measured C1q levels in the blood of 67 patients before and after their surgeries, and found that patients who later developed delirium had notably higher C1q levels than those who did not. Using a statistical measure called the area under the curve (AUC = 0.788), the preoperative C1q test showed a reasonably good ability to distinguish between patients who would and would not develop postoperative delirium. Postoperative delirium is a common and serious complication after major surgeries, particularly involving the heart and major blood vessels. It can lead to longer hospital stays, worse recovery outcomes, and increased risk of long-term cognitive problems. Being able to identify high-risk patients before surgery could allow medical teams to put preventive strategies in place earlier. This research suggests that measuring C1q in the blood before aortic dissection surgery could serve as a practical tool to flag patients at higher risk for postoperative delirium. However, the study was relatively small (67 patients) and further research with larger groups would be needed to confirm these findings and determine how C1q testing might be integrated into clinical care.

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Citation

Wang J, Jiang Y, Liu W, Wang Y, Lu S, Zhu J, et al.. (2026). Serum C1q as a Novel Predictive Biomarker for Postoperative Delirium After Acute Type A Aortic Dissection.. Immunity, inflammation and disease. https://doi.org/10.1002/iid3.70500

Key Findings

What This Means

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