Key result
Higher preoperative neutrophil-to-lymphocyte ratio is linked to postoperative delirium in elderly noncardiac surgery patients.
Why the study?
The study was conducted to assess the correlation between preoperative neutrophil-to-lymphocyte ratio and the risk of postoperative delirium in older patients undergoing noncardiac surgery.
Does a higher preoperative neutrophil-to-lymphocyte ratio predict an increased risk of postoperative delirium in elderly patients undergoing noncardiac surgery?
Meta-Analysis (n=2,424)
Yes
Does a higher preoperative neutrophil-to-lymphocyte ratio predict an increased risk of postoperative delirium in elderly patients undergoing noncardiac surgery?
Mean Difference: 1.06 (95% CI 0.64–1.49)
p-value: p=<0.001
Elevated preoperative neutrophil-to-lymphocyte ratio is significantly associated with an increased risk of postoperative delirium in elderly patients undergoing noncardiac surgery, particularly in orthopaedic procedures and when diagnosed via CAM.
Preoperative NLR elevation may flag POD risk in elderly noncardiac surgery; extends observational data but leaves open prospective validation.
To assess the correlation between preoperative neutrophil-to-lymphocyte ratio (NLR) and risk of postoperative delirium (POD) in older patients undergoing noncardiac surgery. PubMed, Web of Science, Embase, and Scopus were systematically retrieved from inception until February 2023. Two authors independently conducted the selection of literature, data extraction and statistical analysis. In this meta-analysis, Review Manager 5.4 was used for statistical analysis, and the mean difference (MD) and 95% confidence intervals (CIs) of preoperative NLR between the POD group and non-POD group were calculated. We utilised the Newcastle-Ottawa Scale (NOS) to evaluate the quality of literature. Further, our meta-analysis used a random-effects model, and publication bias was evaluated by conducting a funnel plot. The correlation between preoperative NLR and POD was the primary outcome, and the secondary outcome was the association of other prognostic factors with the risk of POD. This meta-analysis included seven studies with 2424 patients, of whom 403 were diagnosed with POD with an incidence of 16.63%. Results indicated a positive correlation between preoperative NLR and the risk of POD (MD = 1.06, 95% CI: 0.64-1.49; P < 0.001). Further, our results found that neutrophil counts, advanced age, longer surgery time, diabetes, and elevated C-reactive protein were significantly associated with POD (MD = 0.98, 95% CI: 0.40-1.56; P = 0.001; MD = 4.20, 95% CI: 2.90-5.51; P < 0.001; MD = 0.15, 95% CI: 0.05-0.25; P < 0.01; OR = 1.42, 95% CI: 1.08-1.86; P = 0.01; MD = 1.26, 95% CI: 0.36-2.16; P < 0.01). Other factors including lymphocyte counts, hypertension and male gender were not significantly associated with POD (MD = -0.11, 95% CI: -0.27 to 0.05; P > 0.05; OR = 1.20, 95% CI: 0.91-1.58, P > 0.05; OR = 1.28, 95% CI: 1.00-1.63; P = 0.05). Our meta-analysis indicated a positive correlation between preoperative NLR and the risk of POD in older noncardiac surgery patients.
No takes yet. Share an insight, caveat, or question.
Zhou et al. (2024) conducted a meta-analysis in Postoperative delirium in elderly patients undergoing noncardiac surgery (n=2,424). Preoperative neutrophil-to-lymphocyte ratio (NLR) vs. Patients without postoperative delirium (non-POD group) was evaluated on Mean difference in preoperative neutrophil-to-lymphocyte ratio (NLR) between postoperative delirium (POD) and non-POD groups (MD 1.06, 95% CI 0.64-1.49, p=<0.001). Preoperative neutrophil-to-lymphocyte ratio was significantly higher in elderly noncardiac surgery patients who developed postoperative delirium compared to those who did not (MD 1.06, P < 0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: