Key result
High preoperative neutrophil-to-lymphocyte ratio linked to ~679% higher postoperative delirium risk in geriatric hip fractures.
Why the study?
Postoperative delirium is an independent risk factor for mortality, institutionalization, and dementia, but its risk factors related to pathogenesis in geriatric hip fracture patients needed investigation.
Does Neutrophil-to-Lymphocyte Ratio (NLR) predict postoperative delirium and its duration in geriatric patients with hip fracture?
Observational (n=1,242)
No
Does Neutrophil-to-Lymphocyte Ratio (NLR) predict postoperative delirium and its duration in geriatric patients with hip fracture?
Effect estimate: OR 7.790 (95% CI 5.350-11.341)
Absolute Event Rate: 35.3% vs 7.3%
p-value: p=<0.001
An elevated Neutrophil-to-Lymphocyte Ratio (≥ 7.6) may serve as a useful biomarker for predicting the occurrence and duration of postoperative delirium in geriatric patients with hip fractures.
Elevated preoperative NLR may flag delirium risk in geriatric hip fracture patients; leaves open whether NLR-guided strategies improve outcomes.
Purpose Postoperative delirium (POD) is an independent risk factor not only for mortality but also for institutionalization and dementia. The purpose of this study was to investigate the risk factors, which is related to the pathogenesis of POD, in geriatric patients with hip fracture. Methods 1,242 Eligible patients with hip fracture were enrolled. Receiver operating characteristic (ROC) curve was performed to identify the optimal cut point of NLR for POD. The relationship between NLR and POD occurrence, NLR and POD duration were analyzed by multivariable analysis. Results ROC curve showed that the optimal cut point of NLR for POD was NLR ≥ 7.6. Multivariate logistic regression analysis showed that NLR ≥ 7.6 (odds ratio [OR] 2.75, [95% confidence interval [CI] 1.51 to 5.02], p = 0.001), stroke (OR 1.05, [95% CI 1.02 to 1.09], p = 0.005), complications, general anesthesia, long length of stay were risk factors of POD, with the largest effect for NLR ≥ 7.6. NLR ≥ 7.6 (OR 0.59, [95% CI 0.209 to 0.886], p = 0.038), older age (OR 0.054, [95% CI 0.009 to 0.099], p = 0.019), previous stroke (OR 0.908, [95% CI 0.085 to 1.731], p = 0.031), and previous heart failure (OR 1.679, [95% CI 0.448 to 2.910], p = 0.008) suggested long POD duration. Conclusions NLR could be used as a potential marker for prediction of POD and POD duration in geriatric patients with hip fracture.
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Zhao et al. (2023) conducted an observational in Geriatric patients with hip fracture (n=1,242). High Neutrophil-to-Lymphocyte Ratio (NLR ≥ 7.6) vs. Low NLR (< 7.6) was evaluated on Postoperative delirium (POD) occurrence (OR 7.790, 95% CI 5.350-11.341, p=<0.001). A high preoperative neutrophil-to-lymphocyte ratio (≥7.6) was independently associated with a significantly increased risk of postoperative delirium (OR 7.790) in geriatric patients with hip fracture.
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