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Postoperative Serum Albumin Decrease Independently Predicts Delirium in the Elderly Subjects after Total Joint

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  • 1Department of anesthesiology, HwaMei Hospital, University of Chinese Academy of Sciences, Beijing, China.

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Postoperative delirium (POD) is a common complication after total joint arthroplasty (TJA). The relative change in serum albumin (ΔAlb) is an independent predictor of POD in elderly patients undergoing TJA.

Keywords:
Postoperative deliriumalbuminelderlyneurobehavioralrisk factortotal joint arthroplasty.

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Area of Science:

  • Geriatric Medicine
  • Neuroscience
  • Surgical Complications

Background:

  • Postoperative delirium (POD) is a frequent and serious neurobehavioral complication following surgery.
  • Elderly patients undergoing total joint arthroplasty (TJA) are particularly susceptible to POD.
  • Identifying predictors for POD is crucial for improving patient outcomes.

Purpose of the Study:

  • To investigate independent predictors for POD in elderly patients after TJA.
  • To evaluate the predictive value of serum albumin changes for POD.
  • To identify modifiable risk factors for POD in this population.

Main Methods:

  • Elderly patients (≥65 years) undergoing elective unilateral primary hip or knee arthroplasty were enrolled.
  • Postoperative delirium diagnosed per DSM-5 criteria.
  • Relative change in serum albumin (ΔAlb) calculated; predictive value assessed using ROC analysis; risk factors identified via logistic regression.

Main Results:

  • Of 328 patients, 68 (20.7%) developed POD.
  • ΔAlb demonstrated significant predictive value for POD (AUC=0.821, P<0.001).
  • Multivariate analysis identified ΔAlb as the sole independent risk factor for POD (OR=2.43, P=0.015).

Conclusions:

  • Relative change in serum albumin (ΔAlb) is an independent risk factor for POD in elderly patients after TJA.
  • Monitoring ΔAlb may aid in identifying patients at high risk for POD.
  • Further research could explore interventions targeting albumin levels to prevent POD.