Clinical Interventions in Aging (May 2022)
The Association Between Systemic Immune-Inflammation Index and Postoperative Cognitive Decline in Elderly Patients
Abstract
Wenbin Lu,1,* Keqin Zhang,1,2,* Xinning Chang,1 Xiya Yu,1 Jinjun Bian1 1Faculty of Anesthesiology, Changhai Hospital, Naval Medical University/Second Military Medical University, PLA, Shanghai, 200433, People’s Republic of China; 2Department of Anesthesiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiya Yu; Jinjun Bian, Faculty of Anesthesiology, Changhai Hospital, Naval Medical Unversity, 168, Changhai Road, Shanghai, 200433, People’s Republic of China, Tel/Fax +86-021-31161886 ; +86-021-31161841, Email [email protected]; [email protected]: Postoperative cognitive decline (POCD) is highly prevalent in elderly patients who received surgery. The systemic immune-inflammation index (SII) has been shown to be an independent predictor of many diseases associated with inflammation, but the relationship between the SII and POCD is unknown. We aimed to investigate the association between POCD and SII levels to examine the potential of SII in predicting POCD in elderly patients.Patients and Methods: The present study was carried out among elderly patients who underwent elective orthopedics operation in our hospital, and SII, neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR) were calculated from the admission blood sample. POCD was measured by Mini-mental State Examination (MMSE) in elderly patients. The association between SII levels and POCD was analyzed by binary logistic regression analysis.Results: Finally, 19 (25%) of 76 patients were diagnosed with POCD. Compared with Non-POCD patients, POCD patients showed significantly higher levels of NLR, MLR, SII, especially SII at admission. SII was independently associated with the occurrence of POCD through the logistic regression analysis. Receiver operating characteristic curve analysis indicated that preoperative SII was a significant predictor for POCD, and the area under the curve was 0.909.Conclusion: Our data suggest that preoperative NLR, MLR, SII levels in the blood are related to the occurrence of POCD. Preoperative SII level is a prognostic biomarker of POCD in elderly patients after orthopedics operation. More clinical studies are needed to further verify the value of SII in POCD.Keywords: systemic immune-inflammation index, postoperative cognitive decline, geriatric, neutrophil to lymphocyte ratio, monocyte to lymphocyte ratio
