The Potential Value of Systemic Inflammation Response Index on Delirium After Hip Arthroplasty Surgery in Older Patients: A Retrospective Study

Abstract

Purpose

To explore the relationship between the systemic inflammation response index (SIRI) and postoperative delirium (POD) in older patients with hip arthroplasty surgery.

Patients and Methods

Older patients who underwent elective hip arthroplasty surgery were included in this retrospective study. SIRI, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were collected from blood routine examination at admission. Binary logistic regression analysis was performed to evaluate the association between SIRI levels and POD was analyzed.

Results

Ultimately, 116 older patients who met the inclusion criteria were assessed. Thirty-four (29%) of 116 patients diagnosed with POD were defined as the POD group, and the rest consisted of the Non-POD group. Compared with non-POD patients, POD patients showed significantly higher levels of SIRI (P < 0.001) and NLR (P = 0.002) at admission. There was no significance in the levels of PLR between two groups. SIRI was independently associated with the occurrence of POD in multivariate logistic regression analysis [odds ratio (OR) = 3.34, 95% confidence interval (95% CI) = 1.26–8.85, P = 0.016]. Receiver operating characteristic curve analysis indicated that SIRI with an optimal cutoff value of 0.987 predicted the POD with a sensitivity of 88.2% and specificity of 74.4%, and the area under the curve was 0.82 (95% CI, 0.74–0.90, P < 0.01).

Conclusion

Preoperative SIRI and NLR levels in the blood are associated with the occurrence of POD. Moreover, preoperative SIRI level is a useful candidate biomarker to identify delirium after elective hip arthroplasty surgery in older patients.

Keywords:

• geriatric
• hip arthroplasty
• neutrophil to lymphocyte ratio
• postoperative delirium
• platelet to lymphocyte ratio
• systemic inflammation response index

Data Sharing Statement

The data supporting the findings of this study can be obtained from the corresponding author according to reasonable request, and the corresponding author/s can be directly contacted for further inquiry.

Ethics Statement

The study concerning human participants was reviewed and approved by the ethics committee of Shanghai Changhai Hospital. The patients/participants participated in the study by providing written informed consent. The study project conforms to the ethical guidelines of the Declaration of Helsinki. In order to publish any potentially identifiable images or data contained in this article, written informed consent was obtained from the individual(s).

Acknowledgments

We thank all those who support and participate in the study, including our staff, patients and their family members. We also thank Xueqian Leng (Faculty of Anesthesiology, Changhai Hospital, Naval Military Medical University) for guidance in revising the manuscript and submission of the manuscript.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors state that the study was conducted without any commercial or financial relationships and potential conflicts of interest.

Additional information

Funding

This study was funded by the National Natural Science Foundation of China (81871579 and 82272205). The sponsor had no role in the manuscript’s design, conduct, drafting, or publication.