ArticlePloS one2021
Availability of preoperative neutrophil-lymphocyte ratio to predict postoperative delirium after head and neck free-flap reconstruction: A retrospective study.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses that pooled it.
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Who cites it
29 citing papers in PubMed, 3 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- A Systematic Review and Meta-Analysis of the Role of Peripheral Inflammation in Delirium.Brain and behavior · 2025Pooled it
- Incidence and risk factors for postoperative delirium after head and neck cancer surgery: an updated meta-analysis.BMC neurology · 2023Pooled 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
- Article
- Observational
- 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
- Prognostic value of the C-reactive protein-albumin-lymphocyte index for postoperative visual hallucinations following cardiac surgery.Frontiers in psychiatry · 2026Article
- Perioperative Profiles of Immune Cells in Patients with Postoperative Delirium After Cardiac Surgery with Cardiopulmonary Bypass.Biomedicines · 2025Article
- Relationship between telomere length and postoperative delirium: a single center prospective observational pilot study.Scientific reports · 2025Observational
- A nomogram model to predict postoperative delirium in esophageal cancer patients undergoing esophagectomy.BMC cancer · 2025Article
- Can Neutrophil-to-Lymphocyte Ratio, Platelet Volume, and Platelet Distribution Width Be Used as Indicators of Delirium?Journal of clinical medicine · 2024Article
- Comprehensive geriatric assessment for predicting postoperative delirium in oral and maxillofacial surgery: a prospective cohort study.Scientific reports · 2024Article
- Predictive value of the Naples prognostic score on postoperative delirium in the elderly with gastrointestinal tumors: a retrospective cohort study.BMC geriatrics · 2024Article
- Association between increased systemic immune-inflammation index and postoperative delirium in older intertrochanteric fracture patients.Journal of orthopaedic surgery and research · 2024Article
- Association between preoperative neutrophil-lymphocyte ratio, uric acid, and postoperative delirium in elderly patients undergoing degenerative spine surgery.Journal of anesthesia · 2024Observational
- Thoracic delirium index for predicting postoperative delirium in elderly patients following thoracic surgery: A retrospective case-control study.Brain and behavior · 2024Observational
- Association of cervical atherosclerosis on Doppler ultrasonography and postoperative delirium in patients undergoing spinal surgery: a single-center, retrospective, observational study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2023Observational
- Hemoglobin-Albumin-Lymphocyte-Platelet (HALP) Score as a Predictive Model for the Success of Reconstruction of Head and Neck Defects with Free Microvascular Flaps.Journal of clinical medicine · 2023Article
- Effect of pharmacist-led intervention protocol on preventing postoperative delirium after elective cardiovascular surgery.PloS one · 2023Article
- Relationship between neutrophil/lymphocyte ratio and postoperative delirium in elderly patients with proximal femoral nail anti-rotation for intertrochanteric fractures.American journal of translational research · 2023Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Postoperative delirium (POD) is a well-recognized postoperative complication and is associated with increased morbidity and mortality. We investigated whether the preoperative neutrophil-lymphocyte ratio (NLR) could be an effective predictor of POD after head and neck free-flap reconstruction. This was a single-center, retrospective, observational study. We analyzed the perioperative data of patients who had undergone elective head and neck free-flap reconstruction surgery. POD was assessed with the Intensive Care Delirium Screening Checklist (ICDSC) during admission to our intensive care unit (ICU). POD was defined as an ICDSC score ≥4. Risk factors for POD were evaluated by univariate and multivariate logistic regression analysis. We included 97 patients. The incidence of POD was 20.6% (20/97). Significantly longer ICU stays were observed in the patients with POD compared to those without POD (median [interquartile range]: 5 [4-6] vs. 4 [4-5], p = 0.031). Higher preoperative NLR values (3 <NLR ≤4 and 4 <NLR) were significantly associated with higher ICDSC scores compared to NLR ≤1 (4 [2-4] vs. 1 [1-1], p = 0.027 and 4 [1-4] vs. 1 [1-1], p = 0.038, respectively). The multivariable logistic regression analysis revealed that only a preoperative NLR >3.0 (adjusted Odds Ratio: 23.6, 95% Confidence Interval: 6.6-85.1; p<0.001) was independently associated with POD. The multivariate area under the receiver operator curve was significantly greater for the E-PRE-DELIRIC model with NLR compared to the E-PRE-DELIRIC model (0.87 vs. 0.60; p<0.001). The preoperative NLR may be a good predictor of POD in patients undergoing head and neck free-flap reconstruction.
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