Elevated Level of Serum C-reactive Protein Predicts Postoperative Delirium among Patients Receiving Cervical or Lumbar Surgery

• Published in: BioMed research international Vol. 2020; no. 2020; pp. 1 - 8
• Main Authors: Xu, Fei, Thapa, Yubaraj, Chen, Xu-hui, Yuan, Jing, Wang, Jin, Wen, Ya-zhou, Ren, Quan, Qiang, Meng-shuang
• Format: Journal Article
• Language: English
• Published: Cairo, Egypt Hindawi Publishing Corporation 2020; Hindawi; John Wiley & Sons, Inc; Hindawi Limited
• Subjects: Aged; Anesthesia; Anesthesia, General - adverse effects; Blood pressure; Bone surgery; C-reactive protein; C-Reactive Protein - metabolism; Cervical Vertebrae - pathology; Cervical Vertebrae - surgery; Cognitive ability; Consciousness; Data analysis; Delirium; Delirium - blood; Delirium - diagnosis; Delirium - pathology; Dementia; Female; Health aspects; Health care facilities; Hospitals; Humans; Inflammation; Logistic Models; Lumbosacral Region - pathology; Lumbosacral Region - surgery; Mental disorders; Middle Aged; Patients; Postoperative Complications - blood; Postoperative Complications - pathology; Proteins; Regression analysis; Regression models; Risk analysis; Risk Factors; Spine; Surgery; Ventilators; Vertebrae; China
• ISSN: 2314-6133; 2314-6141
• DOI: 10.1155/2020/5480148

Objective. To explore the relationship between elevated serum C-reactive protein (CRP) level and postoperative delirium (POD). Methods. 206 patients scheduled to receive cervical or lumbar vertebra surgery under general anesthesia for more than 2 hours in a single medical center were observed and analyzed. Patients’ serum CRP, delirious status (using the confusion assessment method (CAM)), and delirious score (using the memorial delirium assessment scale (MDAS)) were examined before surgery and 1-2 days after surgery. The association of a serum CRP elevation value from before to after surgery (D-CRP) with delirium occurrence within 2 days after surgery was assessed with a binary logistic regression model, while the association of D-CRP with the postoperative delirious score was assessed with a linear regression model. The effect of D-CRP on predicting delirium occurrence was evaluated with the area under the receiver operating characteristic (ROC) curve (AUC). Results. D-CRP was significantly positively associated with postoperative delirium occurrence (OR=1.047, 95%CI=1.013, 1.082), and D-CRP was also significantly linearly associated with the postoperative delirious score (β=0.014, 95%CI=0.006, 0.023). AUC of ROC was 0.711 (P=0.014), suggesting that D-CRP had moderate efficacy on predicting postoperative delirium occurrence (P<0.05). Conclusions. Elevated serum CRP after surgery may be a risk factor for and a predictor of postoperative delirium.