Determining the relationship between serum C-reactive protein (CRP) and delirium after surgery

Abstract

Increased serum C-reactive protein (CRP) level is widely used to indicate acute systemic inflammation in clinical procedures. Elevated CRP has been reported to be associated with some psychiatric disorders. Two large epidemiological studies have shown that elevated CRP levels are associated with dementia. It has even been proven that high levels of CRP can predict the occurrence and improvement of delirium in elderly patients. Furthermore, preoperative CRP was investigated as a risk factor for postoperative delirium in a surgical setting. Therefore, it is reasonable to hypothesize that increased postoperative CRP levels may be associated with the risk of postoperative delirium for surgical patients. Therefore, the present study was conducted with the aim of determining the relationship between serum C-reactive protein (CRP) and delirium after surgery. Methods: This study was a cross-sectional descriptive study with a retrospective approach; Investigated variables: age, gender, body mass index, smoking, underlying diseases, medications, ASA class, emergency or elective surgery, duration of surgery, duration of anesthesia or spinal anesthesia, hemodynamic status (before surgery) during surgery and in the recovery unit, including blood pressure, heart rate, and arterial oxygen saturation) type of surgery, duration of recovery, medications received during general anesthesia or spinal anesthesia, pain intensity in the recovery unit, opioid administration in the recovery unit, duration Length of stay in the hospital, length of stay in the intensive care unit, transfusion of blood and blood products during surgery, transfusion of blood and blood products after surgery, indicators of hemoglobin, hematocrit, platelet, lymphocyte, monocyte and white cells before and After surgery, CRP levels before surgery, delirium score after surgery (based on Necham criteria) were recorded in the data collection form. Results: The level of serum CRP before surgery in the group of patients with delirium was 9.21±2.88 and in the group of patients without delirium it was 3.57±0.74. It was significantly higher than the group of patients without delirium (P=0.005). ROC curve analysis showed high accuracy for preoperative day CRP level to predict postoperative delirium with an AUC of 0.755.