Early postoperative risk prediction of neurocognitive decline

Editor—Perioperative neurocognitive disorders (PNDs) after surgery are associated with higher mortality, increased incidence of other postoperative complications, longer hospital stay, greater need of societal assistance, and earlier retirement.1 PNDs are associated with an exaggerated inflammatory cascade, unresolved inflammatory cascade, or both.2 High molecular group box 1 protein (HMGB1), a damage-associated molecular pattern (DAMP) released from the traumatised tissue, binds to pattern recognition receptors on bone marrow-derived monocytes.