C reactive protein albumin ratio as a new predictor of postoperative delirium after cholecystectomy for acute cholecystitis

• Published in: Scientific reports Vol. 14; no. 1; pp. 21704 - 8
• Main Authors: Nakatake, Richi, Funatsuki, Toshiya, Koshikawa, Yosuke, Okuyama, Tetsuya, Ishizaki, Morihiko, Takekita, Yoshiteru, Kato, Masaki, Kitade, Hiroaki
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 17.09.2024; Nature Publishing Group; Nature Portfolio
• Subjects: 692/308; 692/308/53; 692/499; 692/53; 692/53/2423; Acute cholecystitis; Adult; Aged; Albumin; Biomarkers - blood; C-reactive protein; C-Reactive Protein - analysis; C-Reactive Protein - metabolism; C-reactive protein/albumin ratio; Cholecystectomy; Cholecystectomy - adverse effects; Cholecystitis; Cholecystitis, Acute - blood; Cholecystitis, Acute - surgery; Delirium; Delirium - blood; Delirium - diagnosis; Delirium - etiology; Female; Gallbladder diseases; Humanities and Social Sciences; Humans; Male; Mental disorders; Middle Aged; multidisciplinary; Patients; Postoperative Complications - blood; Postoperative Complications - etiology; Postoperative delirium; Regression analysis; Retrospective Studies; Risk Factors; ROC Curve; Science; Science (multidisciplinary); Serum Albumin - analysis; Serum Albumin - metabolism; Subjective Global Assessment; C-reactive protein/albumin ratio; Postoperative delirium; Acute cholecystitis; Subjective Global Assessment
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-72856-4

Postoperative delirium (POD) is one of the most common complications of surgery. This study aimed to identify the risk factors for POD in patients undergoing cholecystectomy for acute cholecystitis. This retrospective study included 77 patients who underwent cholecystectomy for acute cholecystitis between January 2015, and December 2020. Multiple logistic regression analysis was used to identify the factors associated with the development of delirium as the primary endpoint. Patients were divided into POD (n = 18) and non-POD (n = 59) groups and their demographic features and clinical results were compared. A significant model associated with delirium onset was predicted (Nagelkerke’s R 2  = 0.382), and the significantly correlated factors were C-reactive protein/albumin ratio (CAR), Subjective Global Assessment (SGA) score, and history of psychiatric disease. The predictive value of CAR for POD was evaluated using ROC analysis; the area under the curve of CAR was 0.731, with a cutoff value of 3.69. CAR, SGA score, and a history of psychiatric disease were identified as factors associated with the development of POD in patients with acute cholecystitis. In particular, the new preoperative evaluation of CAR may be beneficial as an assessment measure of the risk factor for the development of POD.