• Thomas N Robinson, Christopher D Raeburn, Erik M Angles, and Marc Moss.
• Department of Surgery, University of Colorado at Denver, Health Sciences Center, 12631 East 17th Ave., Mail Stop C313, PO Box 6511, Aurora, CO 80045, USA. thomas.robinson@uchsc.edu
• Am. J. Surg. 2008 Nov 1;196(5):670-4.

BackgroundPostoperative delirium is a common complication in geriatric patients. Tryptophan is an amino acid precursor to the mood-stabilizing neurotransmitters serotonin and melatonin. We hypothesized that tryptophan levels are lower in elderly subjects who develop postoperative delirium.MethodsA prospective observational study was performed. Subjects older than 50 years undergoing surgery with an anticipated postoperative intensive care unit admission were recruited. Postoperative delirium assessment occurred daily using the Confusion Assessment Method-intensive care unit. Peripheral serum tryptophan levels were measured 2 days after surgery.ResultsForty-nine subjects (46 men) were enrolled, with an average age of 64 +/- 7 years. The incidence of delirium was 43% (21 of 49). The average duration of delirium was 2.9 +/- 3.0 days. Tryptophan levels were lower in the subjects who developed delirium (29.9 +/- 13.3 vs 48.5 +/- 19.8 microg/mL; P = .001).ConclusionsLower levels of tryptophan postoperatively were associated with the development of delirium in the elderly.

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