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Preoperative prognostic nutritional index predicts postoperative delirium in elderly patients after hip fracture surgery
Author(s) -
Xing Hailin,
Xiang Dong,
Li Yunxiang,
Ji Xiaoli,
Xie Guozhu
Publication year - 2020
Publication title -
psychogeriatrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.647
H-Index - 32
eISSN - 1479-8301
pISSN - 1346-3500
DOI - 10.1111/psyg.12511
Subject(s) - medicine , receiver operating characteristic , logistic regression , delirium , odds ratio , incidence (geometry) , multivariate analysis , point of delivery , univariate analysis , area under the curve , hip fracture , surgery , osteoporosis , intensive care medicine , agronomy , physics , optics , biology
Background Postoperative delirium (POD) is a very common complication in elderly patients after hip fracture surgery, which has poorly understood pathophysiology. This study aimed to investigate potential risk factors for POD. Methods Elderly patients (aged ≥65 years) scheduled to undergo selective surgery in our hospital were consecutively recruited. Patient characteristics, preoperative laboratory tests and prognostic nutritional index (PNI) levels were compared between patients with or without POD. The risk factors for POD were evaluated by univariate and multivariate logistic regression analyses. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of PNI and age for POD. Results Fifty‐seven of the 163 enrolled patient had suffered POD within postoperative day 7 with an incidence of 35.0%. Multivariate logistic analyses revealed that an advanced age (cut‐off value: 71.5 years, sensitivity: 48.1%, specificity: 75.4%, odds ratio (OR): 3.24, 95% CI: 1.16–8.69, P = 0.026) and lower PNI level (cut‐off value: 47.45, sensitivity: 86.0%, specificity: 51.9%, OR: 2.88, 95% CI: 1.25–6.64, P = 0.012) were two independent predictive factors associated with POD. According to the ROC curve analysis, preoperative PNI level was a predictor for POD with an area under the curve of 0.686 (95% CI: 0.604–0.767, P < 0.001). Conclusions Advanced age and lower preoperative PNI level were significantly associated with POD in elderly patients after hip fracture surgery.