Journal
CNS NEUROSCIENCE & THERAPEUTICS
Volume 28, Issue 4, Pages 521-530Publisher
WILEY
DOI: 10.1111/cns.13717
Keywords
delirium; elderly patient; the blood-brain barrier; urinary albumin creatinine ratio
Categories
Funding
- National Natural Science Foundation of China [NSFC81720108013, NSFC31771161, NSFC81230025, NSFC81300957]
- Jiangsu Provincial Special Program of Medical Science [BL2014029]
- Basic and Clinical Research Center in Anesthesiology of Jiangsu Provincial Science and Education for Health Project
- Jiangsu Provincial Medical
Ask authors/readers for more resources
This study identified a significant relationship between postoperative delirium and urinary albumin to creatinine ratio (UACR) in elderly patients, suggesting that elevated UACR levels before and after surgery may serve as a predictive factor for postoperative delirium.
Introduction The blood-brain barrier (BBB) disruption contributes to postoperative delirium, but cost-effective and non-invasive assessment of its permeability is not practicable in the clinical settings. Urine albumin to creatinine ratio (UACR), reflecting systemic vascular endothelial dysfunction, may be a prognostic and predictive factor associated with postoperative delirium. The aim was to analyze the relationship between UACR and postoperative delirium in elderly patients undergoing elective non-cardiac surgery. Materials and methods Through stratified random sampling, a cohort of 408 individuals aged 60 years and older scheduled for elective non-cardiac surgery were included between February and August 2019 in the single-center, prospective, observational study. The presence of delirium was assessed using the Confusion Assessment Method (CAM) or Confusion Assessment Method for the ICU (CAM-ICU) on the day of surgery, at 2 h after the surgery ending time and on the first 3 consecutive days with repeated twice-daily, with at least 6-h intervals between assessments. Urine samples were collected on one day before surgery, and 1st day and 3rd day after surgery. The primary outcome was the presence of postoperative delirium, and association of the level of UACR with postoperative delirium was evaluated with unadjusted/adjusted analyses and multivariable logistic regression. Results Postoperative delirium was observed in 26.75% (107 of 400) of patients within 3 days post-surgery. UACR-Pre (OR, 1.30; 95% CI, 1.14-1.49, p < 0.001), UACR-POD1 (OR, 1.20; 95% CI, 1.13-1.27, p < 0.001), and UACR-POD3 (OR, 1.14; 95% CI, 1.08-1.20, p < 0.001) between the delirium and non-delirium groups show a significant difference, even after adjusting for age, education levels, and other factors. Conclusion As the marker of endothelial dysfunction, the high perioperative UACR value may be linked to the postoperative delirium in elderly patients undergoing elective non-cardiac surgery.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available