ArticleThe journals of gerontology. Series A, Biological sciences and medical sciences2024
Inflammatory Indices and Their Associations With Postoperative Delirium.
Article in The journals of gerontology. Series A, Biological sciences and medical sciences, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Dexmedetomidine mitigates postoperative delirium after hip fracture surgery in elderly patients by modulating miR-107 expression.Journal of orthopaedic surgery and research · 2026Article
- Association between tranexamic acid and postoperative delirium in elderly patients: a mediation analysis of inflammatory markers following hip and knee arthroplasty.Frontiers in medicine · 2026Article
- Perioperative predictors of delayed recovery after pancreatic and biliary surgeries: The role of hematologic indices.SAGE open medicine · 2026Article
- The predictive value comparison of the different nutritional assessment tools for postoperative delirium in elderly patients after non-cardiac surgery.Frontiers in nutrition · 2025Article
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19 authors.
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Abstract
backgroundAlthough the pathogenesis of delirium is poorly understood, increasing evidence supports a role for inflammation. Previously, individual inflammatory biomarkers have been associated with delirium. Aggregating biomarkers into an index may provide more information than individual biomarkers in predicting certain health outcomes (eg, mortality); however, inflammatory indices have not yet been examined in delirium.
methodsFour inflammatory markers, C-reactive protein, interleukin-6, soluble tumor necrosis factor alpha receptor-1, and chitinase-3 like protein-1, were measured preoperatively and on postoperative day 2 in 548 adults aged 70+ undergoing major noncardiac surgery (mean age 76.7 [standard deviation 5.2], 58% female, 24% delirium). From these markers, 4 inflammatory indices were considered: (i) quartile summary score, (ii) weighted summary score, (iii) principal component score, and (iv) a well-established inflammatory (least absolute shrinkage and selection operator-derived) index associated with mortality. Delirium was assessed using the Confusion Assessment Method, supplemented by chart review. Generalized linear models with a log-link term were used to determine the association between each inflammatory index and delirium incidence.
resultsAmong the inflammatory indices, the weighted summary score demonstrated the strongest association with delirium: participants in the weighted summary score quartile (Q)4 had a higher risk of delirium versus participants in Q1, after clinical variable adjustment (relative risk, 95% confidence interval for preoperatively: 3.07, 1.80-5.22; and postoperative day 2: 2.65, 1.63-4.30). The weighted summary score was more strongly associated with delirium than the strongest associated individual inflammatory marker (preoperatively chitinase-3 like protein-1 [relative risk 2.45, 95% confidence interval 1.53-3.92]; postoperative day 2 interleukin-6 [relative risk 2.39, 95% confidence interval 1.50-3.82]).
conclusionsA multi-protein inflammatory index using a weighted summary score provides a slight advantage over individual inflammatory markers in their association with delirium.
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