Related Experiment Video
Updated: Jan 21, 2026
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Preoperative C-Reactive Protein/Albumin Ratio, a Risk Factor for Postoperative Delirium in Elderly Patients After
Jie Peng1, Guorong Wu1, Junping Chen1
1Department of Anesthesiology, HwaMei Hospital, University of Chinese Academy of Sciences (Ningbo No.2 Hospital), Ningbo, Zhejiang Province, China.
Background:
Postoperative delirium (POD), as an acute brain failure, is widely reported as a very common postoperative complication, and it is closely associated with increased morbidity and mortality. This study aimed to investigate potential risk factors including C-reactive protein/albumin ratio (CAR) for POD in elderly subjects after total joint arthroplasty (TJA).
Methods:
A total of 272 elderly patients (aged 65∼85 years) who were scheduled to undergo elective TJA with epidural anesthesia were consecutively recruited. The data of baseline characteristics, operation-associated indexes, and preoperative laboratory tests were collected. POD assessment was performed daily within postoperative 7 days. Receiver operating characteristic curve analysis was utilized for evaluating the predictive and cut-off value of CAR for POD. Risk factors for POD were evaluated by the binary univariate and multivariate logistic regression analyses.
Results:
Within postoperative 7 days, there were 55 patients who had suffered POD with an incidence of 20.2% (55/272). The area under the curve of CAR for POD was 0.804, with the cut-off value of 2.35, a sensitivity of 66.82%, and a specificity of 80.00%, respectively (95% confidence interval [CI]: 0.737-0.872, P < .001). Age (odds ratio: 2.02, 95% CI: 1.03-3.96, P = .038) and preoperative CAR level (odds ratio: 3.04, 95% CI: 1.23-7.23, P = .016) were 2 independent risk factors for POD in elderly subjects undergoing TJA.
Conclusions:
Preoperative CAR level may be a promising predictor for POD in elderly subjects following TJA.
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