Association of C-reactive protein to albumin ratio with postoperative delirium and mortality in elderly patients undergoing hip fracture surgery: A retrospective cohort study in a single large center
Background: Postoperative delirium is a common complication in elderly patients who have undergone hip fracture surgery. Since postoperative delirium is associated with poor outcomes and the treatment is very complicated, identifying the patients at high risk for delirium and providing more attentiv...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-02-01
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| Series: | Experimental Gerontology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0531556522003771 |
| _version_ | 1827897324525846528 |
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| author | Ha-Jung Kim Sooho Lee Sung-Hoon Kim Sangho Lee Ji-Hoon Sim Young-Jin Ro |
| author_facet | Ha-Jung Kim Sooho Lee Sung-Hoon Kim Sangho Lee Ji-Hoon Sim Young-Jin Ro |
| author_sort | Ha-Jung Kim |
| collection | DOAJ |
| description | Background: Postoperative delirium is a common complication in elderly patients who have undergone hip fracture surgery. Since postoperative delirium is associated with poor outcomes and the treatment is very complicated, identifying the patients at high risk for delirium and providing more attentive care to prevent postoperative delirium is essential. In this study, we aimed to assess the association of an elevated C-reactive protein (CRP)/albumin ratio with the increased incidence of postoperative delirium in elderly people who had undergone hip fracture surgery. Methods: A total of 629 patients who underwent hip fracture surgery between January 2014 and December 2018 were retrospectively analyzed. Patients were classified into two groups according to preoperative CRP/albumin cut-off levels (<1.5 and ≥1.5). We performed a propensity score matching analysis to compare the incidence of postoperative delirium and overall mortality between the two groups. Multivariate logistic regression and Cox regression analyses were performed to examine the association of the preoperative CRP/albumin ratio with postoperative delirium and overall mortality. Results: There were significant differences in the incidence of postoperative delirium (18.0 % vs. 35.8 %, P < 0.001) and overall mortality (26.7 % vs. 46.9 %, P < 0.001) between the groups before matching. We also observed significant differences in the incidence of postoperative delirium (20.7 % vs. 32.7 %, P = 0.019) and overall mortality (34.7 % vs. 46.0 %, P = 0.046) between the groups after matching. A high CRP/albumin ratio (≥1.5) was significantly associated with a higher incidence of postoperative delirium (adjusted odds ratio [OR]: 2.11, 95 % confidence interval [CI]: 1.40–3.18, P < 0.001) and a higher rate of overall mortality (adjusted hazard ratio [HR]: 1.44, 95 % CI: 1.07–1.93, P = 0.015). Conclusion: Preoperative CRP/albumin ratio might be an independent risk factor of postoperative delirium and surgical prognosis in elderly patients undergoing hip fracture surgery. |
| first_indexed | 2024-03-12T22:47:29Z |
| format | Article |
| id | doaj.art-bfb4424609554fad987efbfd45b78d1d |
| institution | Directory Open Access Journal |
| issn | 1873-6815 |
| language | English |
| last_indexed | 2024-03-12T22:47:29Z |
| publishDate | 2023-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Experimental Gerontology |
| spelling | doaj.art-bfb4424609554fad987efbfd45b78d1d2023-07-21T04:58:43ZengElsevierExperimental Gerontology1873-68152023-02-01172112068Association of C-reactive protein to albumin ratio with postoperative delirium and mortality in elderly patients undergoing hip fracture surgery: A retrospective cohort study in a single large centerHa-Jung Kim0Sooho Lee1Sung-Hoon Kim2Sangho Lee3Ji-Hoon Sim4Young-Jin Ro5Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Catholic Kwandong University, College of Medicine, International St. Mary's hospital, Incheon, South KoreaDepartment of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Corresponding author at: Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-Gil, Songpa-gu, Seoul 05505, Republic of Korea.Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaBackground: Postoperative delirium is a common complication in elderly patients who have undergone hip fracture surgery. Since postoperative delirium is associated with poor outcomes and the treatment is very complicated, identifying the patients at high risk for delirium and providing more attentive care to prevent postoperative delirium is essential. In this study, we aimed to assess the association of an elevated C-reactive protein (CRP)/albumin ratio with the increased incidence of postoperative delirium in elderly people who had undergone hip fracture surgery. Methods: A total of 629 patients who underwent hip fracture surgery between January 2014 and December 2018 were retrospectively analyzed. Patients were classified into two groups according to preoperative CRP/albumin cut-off levels (<1.5 and ≥1.5). We performed a propensity score matching analysis to compare the incidence of postoperative delirium and overall mortality between the two groups. Multivariate logistic regression and Cox regression analyses were performed to examine the association of the preoperative CRP/albumin ratio with postoperative delirium and overall mortality. Results: There were significant differences in the incidence of postoperative delirium (18.0 % vs. 35.8 %, P < 0.001) and overall mortality (26.7 % vs. 46.9 %, P < 0.001) between the groups before matching. We also observed significant differences in the incidence of postoperative delirium (20.7 % vs. 32.7 %, P = 0.019) and overall mortality (34.7 % vs. 46.0 %, P = 0.046) between the groups after matching. A high CRP/albumin ratio (≥1.5) was significantly associated with a higher incidence of postoperative delirium (adjusted odds ratio [OR]: 2.11, 95 % confidence interval [CI]: 1.40–3.18, P < 0.001) and a higher rate of overall mortality (adjusted hazard ratio [HR]: 1.44, 95 % CI: 1.07–1.93, P = 0.015). Conclusion: Preoperative CRP/albumin ratio might be an independent risk factor of postoperative delirium and surgical prognosis in elderly patients undergoing hip fracture surgery.http://www.sciencedirect.com/science/article/pii/S0531556522003771Hip fractureDeliriumAlbuminC-reactive proteinPrognosis |
| spellingShingle | Ha-Jung Kim Sooho Lee Sung-Hoon Kim Sangho Lee Ji-Hoon Sim Young-Jin Ro Association of C-reactive protein to albumin ratio with postoperative delirium and mortality in elderly patients undergoing hip fracture surgery: A retrospective cohort study in a single large center Experimental Gerontology Hip fracture Delirium Albumin C-reactive protein Prognosis |
| title | Association of C-reactive protein to albumin ratio with postoperative delirium and mortality in elderly patients undergoing hip fracture surgery: A retrospective cohort study in a single large center |
| title_full | Association of C-reactive protein to albumin ratio with postoperative delirium and mortality in elderly patients undergoing hip fracture surgery: A retrospective cohort study in a single large center |
| title_fullStr | Association of C-reactive protein to albumin ratio with postoperative delirium and mortality in elderly patients undergoing hip fracture surgery: A retrospective cohort study in a single large center |
| title_full_unstemmed | Association of C-reactive protein to albumin ratio with postoperative delirium and mortality in elderly patients undergoing hip fracture surgery: A retrospective cohort study in a single large center |
| title_short | Association of C-reactive protein to albumin ratio with postoperative delirium and mortality in elderly patients undergoing hip fracture surgery: A retrospective cohort study in a single large center |
| title_sort | association of c reactive protein to albumin ratio with postoperative delirium and mortality in elderly patients undergoing hip fracture surgery a retrospective cohort study in a single large center |
| topic | Hip fracture Delirium Albumin C-reactive protein Prognosis |
| url | http://www.sciencedirect.com/science/article/pii/S0531556522003771 |
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