Albumin/fibrinogen ratio, an independent risk factor for postoperative delirium after total joint arthroplasty

Jiang, Liuying; Lei, Gaofeng

doi:10.1111/ggi.14381

Cited by 12 publications

(23 citation statements)

References 30 publications

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“…After reading the titles and abstracts and excluding irrelevant literature, 45 articles were retained. After excluding duplicate studies and applying the inclusion criteria and exclusion criteria, 25 studies (Priner et al, 2008;Jankowski et al, 2011;Flink et al, 2012;Nandi et al, 2014;Chung et al, 2015;Wang et al, 2016Wang et al, , 2022Yen et al, 2016;Bosmak et al, 2017;Chen et al, 2017Chen et al, , 2021aCunningham et al, 2017Cunningham et al, , 2019Petersen et al, 2017;Aziz et al, 2018;Weinstein et al, 2018;Huang et al, 2019;Memtsoudis et al, 2019;Peng et al, 2019;He et al, 2020;Kijima et al, 2020;Qi et al, 2020;Jiang and Lei, 2022;Lin et al, 2022) including 3,767,761 patients from 9 countries were finally included. One study (Memtsoudis et al, 2019) separately reported the risk factors for delirium after TKA and THA.…”

Section: Literature Screening Process and Resultsmentioning

confidence: 99%

Risk factors for postoperative delirium following total hip or knee arthroplasty: A meta-analysis

et al. 2022

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ObjectivesThe purpose of this study was to identify risk factors for delirium after total joint arthroplasty (TJA) and provide theoretical guidance for reducing the incidence of delirium after TJA.MethodsThe protocol for this meta-analysis is registered with PROSPERO (CRD42020170031). We searched PubMed, the Cochrane Library and Embase for observational studies on risk factors for delirium after TJA. Review Manager 5.3 was used to calculate the relative risk (RR) or standard mean difference (SMD) of potential risk factors related to TJA. STATA 14.0 was used for quantitative publication bias evaluation.ResultsIn total, 25 studies including 3,767,761 patients from 9 countries were included. Old age has been widely recognized as a risk factor for delirium. Our results showed that the main risk factors for delirium after TJA were patient factors (alcohol abuse: RR = 1.63; length of education: SMD = −0.93; and MMSE score: SMD = −0.39), comorbidities (hypertension: RR = 1.26; diabetes mellitus: RR = 1.67; myocardial infarction: RR = 17.75; congestive heart failure: RR = 2.54; dementia: RR = 17.75; renal disease: RR = 2.98; history of stroke: RR = 4.83; and history of mental illness: RR = 2.36), surgical factors (transfusion: RR = 1.53; general anesthesia: RR = 1.10; pre-operative albumin: SMD = −0.38; pre-operative hemoglobin: SMD = −0.29; post-operative hemoglobin: SMD = −0.24; total blood loss: SMD = 0.15; duration of surgery: SMD = 0.29; and duration of hospitalization: SMD = 2.00) and drug factors (benzodiazepine use: RR = 2.14; ACEI use: RR = 1.52; and beta-blocker use: RR = 1.62).ConclusionsMultiple risk factors were associated with delirium after TJA. These results may help doctors predict the occurrence of delirium after surgery and determine the correct treatment.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42020170031.

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Section: Literature Screening Process and Resultsmentioning

confidence: 99%

Risk factors for postoperative delirium following total hip or knee arthroplasty: A meta-analysis

et al. 2022

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“…In our study, functional analysis of the post-operatively dysregulated biomarkers suggests a system-wide activation of the inflammatory cascade and related immunological reactions. Data on the associations between delirium and acute-phase reactants (APR) such as CRP is ubiquitous [20,[44][45][46][47]. Although known APRs correlate well with the severity of inflammation, their usefulness as biomarkers is limited as they are not specific to delirium.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative plasma proteomic changes in cardiac surgery: In search of biomarkers of post‐operative delirium

Wiredu

O’Connor

Naseem

et al. 2023

Proteomics Clinical Apps

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Purpose Delirium presents a significant healthcare burden. It complicates post‐operative care in up to 50% of cardiac surgical patients with worse outcomes, longer hospital stays and higher cost of care. Moreover, the nature of delirium following cardiac surgery with cardiopulmonary bypass (CPB) remains unclear, the underlying pathobiology is poorly understood, status quo diagnostic methods are subjective, and diagnostic biomarkers are currently lacking. Objective To identify diagnostic biomarkers of delirium and for insights into possible neuronal pathomechanisms. Experimental Design Comparative proteomic analyses were performed on plasma samples from a nested matched cohort of patients who underwent cardiac surgery. Validation by targeted proteomics was performed in an independent set of samples. Biomarkers were assessed for biological functions and diagnostic accuracy. Results Forty‐seven percent of subjects demonstrated delirium. Of 3803 proteins identified from patient samples by multiplexed quantitative proteomics, 16 were identified as signatures of exposure to CPB, and 11 biomarkers distinguished delirium cases from non‐cases (AuROC = 93%). Notable among these biomarkers are C‐reactive protein, serum amyloid A‐1 and cathepsin‐B. Conclusions and Clinical Relevance The interplay of systemic and central inflammatory markers sheds new light on delirium pathogenesis. This work suggests that accurate identification of cases may be achievable using panels of biomarkers.

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“…In addition, increasing age is also accompanied with the prevalence of frailty, which is more susceptible to POD [ 25 ]. A recent study by Jiang et al [ 26 ] indicates AFR as an independent risk factor for POD in elderly patients after total joint arthroplasty. In addition, a recent retrospective study suggests that NLR is an independent predictor of poststroke delirium among patients with acute ischemic stroke [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Risk factors and a nomogram model for postoperative delirium in elderly gastric cancer patients after laparoscopic gastrectomy

Chen

Xing

2022

World J Surg Onc

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Background To evaluate the risk factors of postoperative delirium (POD) in elderly gastric cancer (GC) patients after laparoscopic gastrectomy and construct a predictive model. Methods Elderly GC patients undergoing laparoscopic gastrectomy were enrolled and grouped based on the status of POD development within postoperative 7 days. Independent risk factors were selected out by univariate and multivariate logistic regression analyses and then enrolled in the nomogram prediction model. Results A total of 270 elderly GC patients were enrolled, and POD occurred in 74 (27.4%) patients within postoperative 7 days. The results of multivariate regression analysis indicated that age (OR: 3.30, 95% CI: 1.41–6.85, P < 0.001), sleeping pills (OR: 1.87, 95% CI: 1.12–3.09, P = 0.012), duration of ICU stay (OR: 1.55, 95% CI: 1.02–2.37, P = 0.029), albumin/fibrinogen ratio (AFR) (OR: 1.74, 95% CI: 1.03–2.76, P = 0.019), and neutrophils/lymphocytes ratio (NLR) (OR: 2.12, 95% CI: 1.11–4.01, P = 0.016) were five independent risk factors for POD in elderly GC patients. The AUC of the constructed nomogram model based on these five factors was 0.807. Conclusions This study highlighted that age, AFR, NLR, sleeping pills taking, and duration of ICU stay were independent risk factors for POD, and the nomogram model based on these factors could effectively predict POD in elderly GC patients.

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Albumin/fibrinogen ratio, an independent risk factor for postoperative delirium after total joint arthroplasty

Cited by 12 publications

References 30 publications

Risk factors for postoperative delirium following total hip or knee arthroplasty: A meta-analysis

Risk factors for postoperative delirium following total hip or knee arthroplasty: A meta-analysis

Intraoperative plasma proteomic changes in cardiac surgery: In search of biomarkers of post‐operative delirium

Risk factors and a nomogram model for postoperative delirium in elderly gastric cancer patients after laparoscopic gastrectomy

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