Could neutrophil-to-lymphocyte ratio predict the development of delirium in older adults with hip fracture? A pilot study

Background:The neutrophil-to-lymphocyte ratio (NLR) is an inflammatory biomarker.Objective: To evaluate if levels were associated with the development of delirium in older adults hospitalized for hip fracture.Methods: An observational, prospective, analytical pilot study was conducted.Forty participants ≥ 65 years old hospitalized for hip fractures were included.NLR levels were collected from the medical records during the first 24 h of admission of each patient and every 72 h.Results: Twelve participants had delirium.There was no significant difference in the NLR median value at admission in the delirium group versus the no-delirium group (p = 0.768).We found a significant age difference (p = 0.02), cognition (p = 0.004), and activities of daily living (p = 0.004) between groups.In univariate analysis, age ≥ 80 (odds ratio [OR]: 4.22; 95% confidence interval [CI]: 1.0-17.79;p = 0.05), cognitive impairment (OR: 27.0; 95% CI: 2.72-267.79;p = 0.005), and a Lawton and Brody test < 3 score (OR: 13.8; 95% CI: 2.71-7.12;p = 0.002) were associated with an increased risk of delirium.Conclusion: The association between the NLR value and the development of delirium was not observed, but advanced age, moderate/severe cognitive impairment, and decreased instrumental activities of daily living performance were associated with a higher risk of delirium in older adults hospitalized for hip fracture with an increased risk of delirium.