ArticleBMJ open2025
Correlation between complete blood count-derived inflammatory markers and sepsis-associated delirium in older patients: a retrospective analysis of the MIMIC-IV database.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Development and Validation of the Composite Renal-Inflammatory-Nutritional-Metabolic Index for Predicting 28-Day Mortality in Critically Ill Patients.Diagnostics (Basel, Switzerland) · 2026Article
- Association of SIRI and NLPR with post-operative pneumonia in middle-aged and elderly patients after hip fracture surgery.Frontiers in medicine · 2026Article
- Evaluate the Risk Factors of Mild Cognitive Impairment (MCI) in Patients with Type 2 Diabetes Mellitus (T2DM): A Cross-Sectional Study.Diabetes, metabolic syndrome and obesity : targets and therapy · 2026Article
- Machine Learning-Based Prediction of 28-Day Mortality in Patients with Sepsis-Induced Cardiomyopathy: An Integrated Analysis of Inflammatory Biomarkers.Journal of inflammation research · 2026Article
- An interpretable machine learning model for predicting sepsis risk in ICU patients with non-traumatic subarachnoid hemorrhage: development and validation using the MIMIC-IV database.Frontiers in neurologyArticle
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6 authors.
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Abstract
objectivesTo assess the correlation between complete blood count (CBC)-derived inflammatory markers and sepsis-associated delirium (SAD) risk in older intensive care unit (ICU) patients.
designRetrospective cohort study.
settingICUs at Beth Israel Deaconess Medical Center (2008-2019), using the Medical Information Mart for Intensive Care IV V.3.0 database.
participants3412 critically ill patients aged ≥65 years with sepsis. EXCLUSION: repeated ICU admission, death/discharge within 24 hours, missing delirium assessment or pre-sepsis delirium from non-septic aetiologies. SAD was diagnosed by Confusion Assessment Method for the ICU. PRIMARY OUTCOME MEASURE: Incidence of sepsis-associated delirium.
resultsAmong 3412 older sepsis patients, 2092 (61.3%) developed SAD. Significant differences in platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index, systemic inflammation response index, pan-immune-inflammation value and neutrophil-monocyte-to-lymphocyte ratio were observed between SAD and non-SAD groups (all p<0.001). After multivariable adjustment, elevated levels of these markers were associated with increased SAD risk, with MLR showing the strongest association (Q4 vs Q1 adjusted OR=2.66, 95% CI 2.14 to 3.30). Restricted cubic spline analysis revealed non-linear associations between inflammatory marker levels and SAD risk (p for non-linear <0.001). The results of most subgroup analyses were consistent, indicating that the association between inflammatory markers and SAD had high stability (p for interaction >0.05). Receiver operating characteristic and random forest analyses demonstrated predictive utility; incorporating markers into a baseline model significantly improved discrimination, with MLR providing the largest gain (area under the curve (AUC)=0.716 vs 0.703; ΔAUC=0.013, DeLong test, p<0.001).
conclusionCBC-derived inflammatory markers, particularly MLR, are associated with increased SAD risk in older adults and enhance the performance of a clinical prediction model in this population. Further research is needed to better understand the pathophysiological mechanisms underlying these associations.
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