Linear association between high-sensitivity C-reactive protein and postoperative delirium after general anesthesia: a cross-sectional study
ObjectiveTo investigate the association between high-sensitivity C-reactive protein (Hs-CRP) levels and the risk of postoperative delirium (POD) following general anesthesia.MethodsThis retrospective cross-sectional study included 644 patients who underwent general anesthesia. Univariate and multiva...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1516800/full |
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| author | Xiao Qin Junming Ren Chunping Xing Lijiao Chen Renjie Wang Shouyuan Tian |
| author_facet | Xiao Qin Junming Ren Chunping Xing Lijiao Chen Renjie Wang Shouyuan Tian |
| author_sort | Xiao Qin |
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| description | ObjectiveTo investigate the association between high-sensitivity C-reactive protein (Hs-CRP) levels and the risk of postoperative delirium (POD) following general anesthesia.MethodsThis retrospective cross-sectional study included 644 patients who underwent general anesthesia. Univariate and multivariate logistic regression analyses were performed to evaluate the relationship between Hs-CRP and POD, with subgroup analyses used to assess stratified associations. Receiver operator characteristic (ROC) curve analysis was employed to assess the predictive efficacy of Hs-CRP for POD. Restricted cubic spline (RCS) analysis was conducted to explore the linear relationship between the log-transformed Hs-CRP (Log10Hs-CRP) and POD risk.ResultsThe total population consisted of 644 individuals with a mean age of 64.02 ± 13.20 years, 506 (78.60%) of whom were male, and 114 patients (17.7%) had POD. Compared to the lower Hs-CRP group, patients in the higher Hs-CRP group exhibited higher age, heart rate, white blood cell count, blood urea nitrogen, creatinine, uric acid, fasting glucose, hemoglobin A1c, fibrinogen, D-dimer, and a higher prevalence of CKD, but lower hemoglobin, high-density lipoprotein cholesterol, albumin and estimated glomerular filtration rate. Additionally, the prevalence of POD was higher in the higher Hs-CRP group (24.7% vs. 9.5%, p < 0.001). Multivariate logistic regression confirmed that elevated Hs-CRP and its forms (Log10Hs-CRP, standardized Hs-CRP, and higher Hs-CRP group) consistently increased the risk of POD across all adjusted models (p < 0.05). Stratified analyses further highlighted significant associations between Hs-CRP and POD in specific subgroups, notably in patients aged ≥65 years, female patients, and those with or without hypertension, diabetes, or stroke history, and without chronic kidney disease (p < 0.05). ROC curve analysis demonstrated that Hs-CRP had a significant predictive ability for POD in the overall population (AUC = 0.646), as well as in male (AUC = 0.644) and female patients (AUC = 0.654). Additionally, RCS analysis indicated a linear positive association between Log10Hs-CRP and POD risk (p = 0.003, nonlinear p = 0.896).ConclusionElevated Hs-CRP levels are significantly associated with an increased risk of POD following general anesthesia. |
| format | Article |
| id | doaj-art-f25a4baecc76474a8f82f19e3eda5d0b |
| institution | Kabale University |
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| publishDate | 2025-01-01 |
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| spelling | doaj-art-f25a4baecc76474a8f82f19e3eda5d0b2025-01-31T14:49:53ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-01-011610.3389/fneur.2025.15168001516800Linear association between high-sensitivity C-reactive protein and postoperative delirium after general anesthesia: a cross-sectional studyXiao Qin0Junming Ren1Chunping Xing2Lijiao Chen3Renjie Wang4Shouyuan Tian5Department of Anesthesiology, Sixth Hospital of Shanxi Medical University, General Hospital of Tisco, Taiyuan, ChinaDepartment of Anesthesiology, Shanxi Provincial People's Hospital, Taiyuan, ChinaDepartment of Anesthesiology, Sixth Hospital of Shanxi Medical University, General Hospital of Tisco, Taiyuan, ChinaDepartment of Anesthesiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Urology, General Hospital of Tisco, Sixth Hospital of Shanxi Medical University, Taiyuan, ChinaShanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, ChinaObjectiveTo investigate the association between high-sensitivity C-reactive protein (Hs-CRP) levels and the risk of postoperative delirium (POD) following general anesthesia.MethodsThis retrospective cross-sectional study included 644 patients who underwent general anesthesia. Univariate and multivariate logistic regression analyses were performed to evaluate the relationship between Hs-CRP and POD, with subgroup analyses used to assess stratified associations. Receiver operator characteristic (ROC) curve analysis was employed to assess the predictive efficacy of Hs-CRP for POD. Restricted cubic spline (RCS) analysis was conducted to explore the linear relationship between the log-transformed Hs-CRP (Log10Hs-CRP) and POD risk.ResultsThe total population consisted of 644 individuals with a mean age of 64.02 ± 13.20 years, 506 (78.60%) of whom were male, and 114 patients (17.7%) had POD. Compared to the lower Hs-CRP group, patients in the higher Hs-CRP group exhibited higher age, heart rate, white blood cell count, blood urea nitrogen, creatinine, uric acid, fasting glucose, hemoglobin A1c, fibrinogen, D-dimer, and a higher prevalence of CKD, but lower hemoglobin, high-density lipoprotein cholesterol, albumin and estimated glomerular filtration rate. Additionally, the prevalence of POD was higher in the higher Hs-CRP group (24.7% vs. 9.5%, p < 0.001). Multivariate logistic regression confirmed that elevated Hs-CRP and its forms (Log10Hs-CRP, standardized Hs-CRP, and higher Hs-CRP group) consistently increased the risk of POD across all adjusted models (p < 0.05). Stratified analyses further highlighted significant associations between Hs-CRP and POD in specific subgroups, notably in patients aged ≥65 years, female patients, and those with or without hypertension, diabetes, or stroke history, and without chronic kidney disease (p < 0.05). ROC curve analysis demonstrated that Hs-CRP had a significant predictive ability for POD in the overall population (AUC = 0.646), as well as in male (AUC = 0.644) and female patients (AUC = 0.654). Additionally, RCS analysis indicated a linear positive association between Log10Hs-CRP and POD risk (p = 0.003, nonlinear p = 0.896).ConclusionElevated Hs-CRP levels are significantly associated with an increased risk of POD following general anesthesia.https://www.frontiersin.org/articles/10.3389/fneur.2025.1516800/fullinflammationhigh-sensitivity C-reactive proteinpostoperative deliriumgeneral anesthesiarestricted cubic spline |
| spellingShingle | Xiao Qin Junming Ren Chunping Xing Lijiao Chen Renjie Wang Shouyuan Tian Linear association between high-sensitivity C-reactive protein and postoperative delirium after general anesthesia: a cross-sectional study Frontiers in Neurology inflammation high-sensitivity C-reactive protein postoperative delirium general anesthesia restricted cubic spline |
| title | Linear association between high-sensitivity C-reactive protein and postoperative delirium after general anesthesia: a cross-sectional study |
| title_full | Linear association between high-sensitivity C-reactive protein and postoperative delirium after general anesthesia: a cross-sectional study |
| title_fullStr | Linear association between high-sensitivity C-reactive protein and postoperative delirium after general anesthesia: a cross-sectional study |
| title_full_unstemmed | Linear association between high-sensitivity C-reactive protein and postoperative delirium after general anesthesia: a cross-sectional study |
| title_short | Linear association between high-sensitivity C-reactive protein and postoperative delirium after general anesthesia: a cross-sectional study |
| title_sort | linear association between high sensitivity c reactive protein and postoperative delirium after general anesthesia a cross sectional study |
| topic | inflammation high-sensitivity C-reactive protein postoperative delirium general anesthesia restricted cubic spline |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1516800/full |
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