Prospective Analysis Between Neutrophil-to-Lymphocyte Ratio on Admission and Development of Delirium Among Older Hospitalized Patients With COVID-19
Objective: To examine any prospective association between neutrophil-to-lymphocyte ratio (NLR) at hospital admission and subsequent delirium in older COVID-19 hospitalized patients comparing by sex and age groups.Methods: The sample consisted of 1,785 COVID-19 adult inpatients (minimum sample size r...
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| Format: | Article |
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Frontiers Media S.A.
2021-11-01
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| Series: | Frontiers in Aging Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnagi.2021.764334/full |
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| author | Eduardo Fernández-Jiménez Eduardo Fernández-Jiménez Ainoa Muñoz-Sanjose Ainoa Muñoz-Sanjose Roberto Mediavilla Roberto Mediavilla Gonzalo Martínez-Alés Gonzalo Martínez-Alés Gonzalo Martínez-Alés Iker I. Louzao Jorge Andreo Susana Cebolla Susana Cebolla María-Fe Bravo-Ortiz María-Fe Bravo-Ortiz María-Fe Bravo-Ortiz María-Fe Bravo-Ortiz Carmen Bayón Carmen Bayón Carmen Bayón |
| author_facet | Eduardo Fernández-Jiménez Eduardo Fernández-Jiménez Ainoa Muñoz-Sanjose Ainoa Muñoz-Sanjose Roberto Mediavilla Roberto Mediavilla Gonzalo Martínez-Alés Gonzalo Martínez-Alés Gonzalo Martínez-Alés Iker I. Louzao Jorge Andreo Susana Cebolla Susana Cebolla María-Fe Bravo-Ortiz María-Fe Bravo-Ortiz María-Fe Bravo-Ortiz María-Fe Bravo-Ortiz Carmen Bayón Carmen Bayón Carmen Bayón |
| author_sort | Eduardo Fernández-Jiménez |
| collection | DOAJ |
| description | Objective: To examine any prospective association between neutrophil-to-lymphocyte ratio (NLR) at hospital admission and subsequent delirium in older COVID-19 hospitalized patients comparing by sex and age groups.Methods: The sample consisted of 1,785 COVID-19 adult inpatients (minimum sample size required of 635 participants) admitted to a public general hospital in Madrid (Spain) between March 16th and April 15th, 2020. Variables were obtained from electronic health records. Binary logistic regression models were performed between baseline NLR and delirium adjusting for age, sex, medical comorbidity, current illness severity, serious mental illness history and use of chloroquine and dexamethasone. An NLR cut-off was identified, and stratified analyses were performed by age and sex. Also, another biomarker was tested as an exposure (the systemic immune-inflammation index –SII).Results: 55.3% of the patients were men, with a mean age of 66.8 years. Roughly 13% of the patients had delirium during hospitalization. NLR on admission predicted subsequent delirium development (adjusted OR = 1.02, 95 percent CI: 1.00–1.04, p = 0.024). Patients between 69 and 80 years with NLR values > 6.3 presented a twofold increased risk for delirium (p = 0.004). There were no sex differences in the association between baseline NLR and delirium (p > 0.05) nor SII predicted delirium development (p = 0.341).Conclusion: NLR is a good predictor of delirium during hospitalization, especially among older adults, independently of medical comorbidity, illness severity, and other covariates. Routine blood tests on admission might provide valuable information to guide the decision-making process to be followed with these especially vulnerable patients. |
| first_indexed | 2024-12-13T16:23:45Z |
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| id | doaj.art-815d8226e83145a2a9168da17a38a024 |
| institution | Directory Open Access Journal |
| issn | 1663-4365 |
| language | English |
| last_indexed | 2024-12-13T16:23:45Z |
| publishDate | 2021-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Aging Neuroscience |
| spelling | doaj.art-815d8226e83145a2a9168da17a38a0242022-12-21T23:38:39ZengFrontiers Media S.A.Frontiers in Aging Neuroscience1663-43652021-11-011310.3389/fnagi.2021.764334764334Prospective Analysis Between Neutrophil-to-Lymphocyte Ratio on Admission and Development of Delirium Among Older Hospitalized Patients With COVID-19Eduardo Fernández-Jiménez0Eduardo Fernández-Jiménez1Ainoa Muñoz-Sanjose2Ainoa Muñoz-Sanjose3Roberto Mediavilla4Roberto Mediavilla5Gonzalo Martínez-Alés6Gonzalo Martínez-Alés7Gonzalo Martínez-Alés8Iker I. Louzao9Jorge Andreo10Susana Cebolla11Susana Cebolla12María-Fe Bravo-Ortiz13María-Fe Bravo-Ortiz14María-Fe Bravo-Ortiz15María-Fe Bravo-Ortiz16Carmen Bayón17Carmen Bayón18Carmen Bayón19Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, SpainHospital La Paz Institute for Health Research (IdiPAZ), Madrid, SpainDepartment of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, SpainHospital La Paz Institute for Health Research (IdiPAZ), Madrid, SpainDepartment of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, SpainCentro de Investigación Biomédica en Red (CIBERSAM), Madrid, SpainDepartment of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, SpainCentro de Investigación Biomédica en Red (CIBERSAM), Madrid, SpainDepartment of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United StatesDepartment of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, SpainHospital La Paz Institute for Health Research (IdiPAZ), Madrid, SpainDepartment of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, SpainHospital La Paz Institute for Health Research (IdiPAZ), Madrid, SpainDepartment of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, SpainHospital La Paz Institute for Health Research (IdiPAZ), Madrid, SpainDepartment of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, SpainCentro de Investigación Biomédica en Red (CIBERSAM), Madrid, SpainDepartment of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, SpainHospital La Paz Institute for Health Research (IdiPAZ), Madrid, SpainDepartment of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, SpainObjective: To examine any prospective association between neutrophil-to-lymphocyte ratio (NLR) at hospital admission and subsequent delirium in older COVID-19 hospitalized patients comparing by sex and age groups.Methods: The sample consisted of 1,785 COVID-19 adult inpatients (minimum sample size required of 635 participants) admitted to a public general hospital in Madrid (Spain) between March 16th and April 15th, 2020. Variables were obtained from electronic health records. Binary logistic regression models were performed between baseline NLR and delirium adjusting for age, sex, medical comorbidity, current illness severity, serious mental illness history and use of chloroquine and dexamethasone. An NLR cut-off was identified, and stratified analyses were performed by age and sex. Also, another biomarker was tested as an exposure (the systemic immune-inflammation index –SII).Results: 55.3% of the patients were men, with a mean age of 66.8 years. Roughly 13% of the patients had delirium during hospitalization. NLR on admission predicted subsequent delirium development (adjusted OR = 1.02, 95 percent CI: 1.00–1.04, p = 0.024). Patients between 69 and 80 years with NLR values > 6.3 presented a twofold increased risk for delirium (p = 0.004). There were no sex differences in the association between baseline NLR and delirium (p > 0.05) nor SII predicted delirium development (p = 0.341).Conclusion: NLR is a good predictor of delirium during hospitalization, especially among older adults, independently of medical comorbidity, illness severity, and other covariates. Routine blood tests on admission might provide valuable information to guide the decision-making process to be followed with these especially vulnerable patients.https://www.frontiersin.org/articles/10.3389/fnagi.2021.764334/fullneutrophil-to-lymphocyte ratio (NLR)deliriumCOVID-19hospitalizationolder adults |
| spellingShingle | Eduardo Fernández-Jiménez Eduardo Fernández-Jiménez Ainoa Muñoz-Sanjose Ainoa Muñoz-Sanjose Roberto Mediavilla Roberto Mediavilla Gonzalo Martínez-Alés Gonzalo Martínez-Alés Gonzalo Martínez-Alés Iker I. Louzao Jorge Andreo Susana Cebolla Susana Cebolla María-Fe Bravo-Ortiz María-Fe Bravo-Ortiz María-Fe Bravo-Ortiz María-Fe Bravo-Ortiz Carmen Bayón Carmen Bayón Carmen Bayón Prospective Analysis Between Neutrophil-to-Lymphocyte Ratio on Admission and Development of Delirium Among Older Hospitalized Patients With COVID-19 Frontiers in Aging Neuroscience neutrophil-to-lymphocyte ratio (NLR) delirium COVID-19 hospitalization older adults |
| title | Prospective Analysis Between Neutrophil-to-Lymphocyte Ratio on Admission and Development of Delirium Among Older Hospitalized Patients With COVID-19 |
| title_full | Prospective Analysis Between Neutrophil-to-Lymphocyte Ratio on Admission and Development of Delirium Among Older Hospitalized Patients With COVID-19 |
| title_fullStr | Prospective Analysis Between Neutrophil-to-Lymphocyte Ratio on Admission and Development of Delirium Among Older Hospitalized Patients With COVID-19 |
| title_full_unstemmed | Prospective Analysis Between Neutrophil-to-Lymphocyte Ratio on Admission and Development of Delirium Among Older Hospitalized Patients With COVID-19 |
| title_short | Prospective Analysis Between Neutrophil-to-Lymphocyte Ratio on Admission and Development of Delirium Among Older Hospitalized Patients With COVID-19 |
| title_sort | prospective analysis between neutrophil to lymphocyte ratio on admission and development of delirium among older hospitalized patients with covid 19 |
| topic | neutrophil-to-lymphocyte ratio (NLR) delirium COVID-19 hospitalization older adults |
| url | https://www.frontiersin.org/articles/10.3389/fnagi.2021.764334/full |
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