Department of Anesthesiology, Zhongda Hospital and School of Medicine, Southeast University, 87 Dingjiaqiao Rd, Nanjing, Jiangsu 210009, China.
Ophthalmology Department, Tongji Hospital, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei 430030, China.
Biomed Res Int. 2020 Aug 10;2020:5480148. doi: 10.1155/2020/5480148. eCollection 2020.
To explore the relationship between elevated serum C-reactive protein (CRP) level and postoperative delirium (POD).
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).
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 ( = 0.014, 95%CI = 0.006, 0.023). AUC of ROC was 0.711 ( = 0.014), suggesting that D-CRP had moderate efficacy on predicting postoperative delirium occurrence ( < 0.05).
Elevated serum CRP after surgery may be a risk factor for and a predictor of postoperative delirium.
探讨血清 C 反应蛋白（CRP）水平升高与术后谵妄（POD）的关系。
观察并分析了在单一医疗中心接受全麻下颈椎或腰椎手术且手术时间超过 2 小时的 206 例患者。患者在术前及术后 1-2 天分别检测血清 CRP、谵妄状态（采用意识模糊评估法（CAM））和谵妄评分（采用记忆障碍评估量表（MDAS））。采用二元逻辑回归模型评估术前至术后 CRP 升高值（D-CRP）与术后 2 天内谵妄发生的相关性，采用线性回归模型评估 D-CRP 与术后谵妄评分的相关性。采用受试者工作特征（ROC）曲线下面积（AUC）评价 D-CRP 预测谵妄发生的效果。
D-CRP 与术后谵妄发生显著正相关（OR=1.047，95%CI=1.013，1.082），D-CRP 与术后谵妄评分也显著呈线性相关（ =0.014，95%CI=0.006，0.023）。ROC 曲线的 AUC 为 0.711（ =0.014），表明 D-CRP 对预测术后谵妄发生具有中等疗效（ <0.05）。
术后血清 CRP 升高可能是术后谵妄的危险因素和预测指标。
