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  11. C Reactive Protein Albumin Ratio As A New Predictor Of Postoperative Delirium After Cholecystectomy For Acute Cholecystitis

C reactive protein albumin ratio as a new predictor of postoperative delirium after cholecystectomy for acute cholecystitis

Richi Nakatake1,2, Toshiya Funatsuki3, Yosuke Koshikawa3

  • 1Department of Hepato-Biliary-Pancreatic Surgery, Kansai Medical University Medical Center, 10-15 Fumizono-Cho, Moriguchi, Osaka, 573-1010, Japan. nakatakr@hirakata.kmu.ac.jp.

Scientific Reports
|September 17, 2024

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View abstract on PubMed

Summary
This summary is machine-generated.

Postoperative delirium (POD) is common after surgery. The C-reactive protein/albumin ratio (CAR), Subjective Global Assessment (SGA) score, and psychiatric history are key risk factors for POD in acute cholecystitis patients.

Area of Science:

  • Surgery
  • Critical Care Medicine
  • Geriatric Medicine

Background:

  • Postoperative delirium (POD) is a frequent complication following surgical procedures.
  • Acute cholecystitis necessitates surgical intervention, increasing patient vulnerability to POD.
  • Identifying POD risk factors is crucial for improving patient outcomes.

Purpose of the Study:

  • To determine the risk factors associated with the development of POD in patients undergoing cholecystectomy for acute cholecystitis.
  • To evaluate the predictive value of the C-reactive protein/albumin ratio (CAR) for POD.
  • To identify clinical indicators for POD risk stratification in this patient cohort.

Main Methods:

  • Retrospective analysis of 77 patients who underwent cholecystectomy for acute cholecystitis (January 2015 - December 2020).
Keywords:
Acute cholecystitisC-reactive protein/albumin ratioPostoperative deliriumSubjective Global Assessment

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  • Logistic regression analysis to identify factors correlated with delirium development.
  • Receiver Operating Characteristic (ROC) analysis to assess the predictive performance of CAR.

    • Main Results:

    • A predictive model for delirium onset was established (Nagelkerke's R² = 0.382).
    • Significant risk factors identified: C-reactive protein/albumin ratio (CAR), Subjective Global Assessment (SGA) score, and history of psychiatric disease.
    • CAR demonstrated predictive value for POD with an area under the curve of 0.731 (cutoff value 3.69).

    Conclusions:

    • CAR, SGA score, and a history of psychiatric disease are significant factors associated with POD in acute cholecystitis patients.
    • Preoperative assessment of CAR may serve as a valuable tool for predicting POD risk.
    • These findings can inform targeted interventions to mitigate POD incidence.