ArticleBMC psychiatry2020
Association between increased neutrophil-to-lymphocyte ratio and postoperative delirium in elderly patients with total hip arthroplasty for hip fracture.
Article in BMC psychiatry, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07741175 (Evaluation of the Efficiency of Neutrophil-Lymphocyte Ratio in Predicting Delirium in Geriatric Patients Undergoing Hip Fracture Surgery), which is not on this map. Cited by 46 papers, 8 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Evaluation of the Efficiency of Neutrophil-Lymphocyte Ratio in Predicting Delirium in Geriatric Patients Undergoing Hip Fracture Surgery
Who cites it
46 citing papers in PubMed, 8 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- Association of multidimensional biomarkers of immune, nutritional, inflammatory, and metabolic status with postoperative outcomes in older hip fracture patients: a systematic review and meta-analysis.Frontiers in nutrition · 2026Pooled it
- A Systematic Review and Meta-Analysis of the Role of Peripheral Inflammation in Delirium.Brain and behavior · 2025Pooled it
- Incidence and factors associated with postoperative delirium after primary total joint arthroplasty in older adults: a systematic review and meta-analysis.Frontiers in medicine · 2025Pooled it
- Risk factors for postoperative delirium in patients undergoing orthopedic procedures: a systematic review and meta-analysis.PloS one · 2025Pooled it
- Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as prognostic predictors for delirium in critically ill patients: a systematic review and meta-analysis.BMC anesthesiology · 2023Pooled it
- Predisposing and Precipitating Factors Associated With Delirium: A Systematic Review.JAMA network open · 2023Pooled it
- Risk factors for postoperative delirium following total hip or knee arthroplasty: A meta-analysis.Frontiers in psychology · 2022Pooled it
- Risk factors for postoperative delirium in geriatric patients with hip fracture: A systematic review and meta-analysis.Frontiers in aging neuroscience · 2022Pooled it
- Dexmedetomidine potential in attenuating postoperative delirium in elderly patients after total hip joint replacement.Revista da Associacao Medica Brasileira (1992) · 2022Trial
- Article
- Preoperative and early postoperative neutrophil-to-lymphocyte ratio for predicting delirium after laparoscopic gynecologic surgery in elderly women: a retrospective cohort study with an outcome-matched nested case-control analysis and internal validation.Anesthesia and pain medicine · 2026Article
- Development of a Nomogram-Based Prediction Model for Postoperative Delirium in Patients After Total Hip Arthroplasty: A Retrospective Cohort Study.Nursing open · 2026Article
- Prognostic value of the C-reactive protein-albumin-lymphocyte index for postoperative visual hallucinations following cardiac surgery.Frontiers in psychiatry · 2026Article
- A clinical prediction model for postoperative delirium following surgical treatment of femoral fractures in older adult patients: development and validation study.BMC anesthesiology · 2025Article
- Age affects the immune system more than a moderate surgical trauma and anesthesia.Scientific reports · 2025Article
- Correlation of Preoperative Inflammation/Immunity Markers With Postoperative Urinary Tract Infections in Elderly Hip Fracture Patients.Orthopaedic surgery · 2025Article
- Systemic immune-inflammation index and postoperative sleep disturbance in elderly patients with total joint arthroplasty: A prospective cohort study.Scientific reports · 2025Article
- A nomogram model to predict postoperative delirium in esophageal cancer patients undergoing esophagectomy.BMC cancer · 2025Article
- Remimazolam-Based Anesthesia and Systemic Inflammatory Biomarkers in Relation to Postoperative Delirium in Elderly Patients: A Retrospective Cohort Study.Medicina (Kaunas, Lithuania) · 2025Article
- The Role of Stress Hyperglycemia on Delirium Onset.Journal of clinical medicine · 2025Review
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDelirium is a common complication in elderly patients with total hip arthroplasty (THA) for hip fracture. The mechanism of postoperative delirium (POD) is associated with the neuroinflammatory process. The aim of this study was to the incidence and perioperative risk factors of POD and investigate whether NLR could serve as a potential marker for POD in elderly patients with THA for hip fracture.
methodsThis was a multicenter prospective study, we included elderly patients with THA for hip fracture under general anesthesia. Receiver operating characteristic (ROC) curve was performed to identify the optimal cut point of NLR for POD. The relationship between NLR and POD was analyzed by multivariable analysis.
resultsSeven hundred eighty patients (mean age 73.33 ± 7.66) were eligible for inclusion in the study. 23.33% (182/780) of patients had POD. ROC curve analysis showed that the optimal cut point of NLR for POD was NLR ≥ 3.5. Compared with no POD, higher NLR, older age, diabetes, and higher neutrophil count were more likely in patients with POD(P < 0.05). Multivariate logistic regression analysis showed that NLR ≥ 3.50 [adjusted odds ratio(aOR), 3.93; confidence interval (CI), 2.47-6.25; P < 0.001)], older age (aOR, 1.04; 95%CI, 1.02-1.07; P = 0.001), diabetes (aOR, 1.58; 95% CI, 1.06-2.36; P = 0.025),higher neutrophil count (aOR, 1.25; 95%CI, 1.15-1.35; P < 0.001) were associated with increased risk of POD.
conclusionsOlder age, diabetes, higher neutrophil count, and NLR ≥ 3.5 were independent risk factors for POD, and NLR can be used as a potential marker for prediction of delirium in elderly patients with THA for hip fracture.
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