The Potential Value of Systemic Inflammation Response Index on Delirium After Hip Arthroplasty Surgery in Older Patients: A Retrospective Study

Abstract

Wenbin Lu,* Shengwei Lin,* Cheng Wang, Peipei Jin, Jinjun Bian Faculty of Anesthesiology, Changhai Hospital, Naval Medical University/Second Military Medical University, PLA, Shanghai, 200433, People’s Republic of China*These authors contributed equally to this workCorrespondence: Peipei Jin; Jinjun Bian, Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, 168, Changhai Road, Shanghai, 200433, People’s Republic of China, Tel/Fax [phone], Email [email protected]; [email protected]: To explore the relationship between the systemic inflammation response index (SIRI) and postoperative delirium (POD) in older patients with hip arthroplasty surgery.Patients and Methods: Older patients who underwent elective hip arthroplasty surgery were included in this retrospective study. SIRI, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were collected from blood routine examination at admission. Binary logistic regression analysis was performed to evaluate the association between SIRI levels and POD was analyzed.Results: Ultimately, 116 older patients who met the inclusion criteria were assessed. Thirty-four (29%) of 116 patients diagnosed with POD were defined as the POD group, and the rest consisted of the Non-POD group. Compared with non-POD patients, POD patients showed significantly higher levels of SIRI (P < 0.001) and NLR (P = 0.002) at admission. There was no significance in the levels of PLR between two groups. SIRI was independently associated with the occurrence of POD in multivariate logistic regression analysis [odds ratio (OR) = 3.34, 95% confidence interval (95% CI) = 1.26– 8.85, P = 0.016]. Receiver operating characteristic curve analysis indicated that SIRI with an optimal cutoff value of 0.987 predicted the POD with a sensitivity of 88.2% and specificity of 74.4%, and the area under the curve was 0.82 (95% CI, 0.74– 0.90, P < 0.01).Conclusion: Preoperative SIRI and NLR levels in the blood are associated with the occurrence of POD. Moreover, preoperative SIRI level is a useful candidate biomarker to identify delirium after elective hip arthroplasty surgery in older patients.Keywords: geriatric, hip arthroplasty, neutrophil to lymphocyte ratio, postoperative delirium, platelet to lymphocyte ratio, systemic inflammation response index

Keywords

• geriatric
• hip arthroplasty
• neutrophil to lymphocyte ratio
• postoperative delirium
• platelet to lymphocyte ratio
• systemic inflammation response index