Association Between Preoperative Lymphocyte-to-Monocyte Ratio and Postoperative Delirium According to Frailty Status in Older Surgical Patients: A Prospective Cohort Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 6,475
- 试验地点
- 1
- 主要终点
- The primary outcome was the occurrence of postoperative delirium (POD).
研究概览
简要总结
Both frailty and a reduced preoperative lymphocyte-to-monocyte ratio (LMR) are known risk factors for postoperative delirium (POD). However, whether the relationship between LMR and POD varies by frailty status remains unclear. This study aimed to evaluate the frailty-stratified association between preoperative LMR and POD in older surgical patients.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 65 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Aged ≥65 years;
- •Underwent elective noncardiac, nonneurosurgical procedures;
- •Completed the preoperative health and functional status questionnaire.
排除标准
- •Severe dementia, language disorders, significant hearing or visual impairments, or coma;
- •Cognitive function below the Mini-Mental State Examination thresholds (<18 for illiterate individuals, <21 for individuals with primary education, and <25 for individuals with secondary education or higher);
- •Surgery performed under local anesthesia or monitored anesthesia care;
- •Missing lymphocyte or monocyte count data;
- •Missing postoperative delirium assessment;
- •Incomplete preoperative FRAIL scale evaluation;
- •Missing data for more than 20% of covariates.
研究组 & 干预措施
A retrospective cohort study based on prospectively collected data.
Patients were grouped according to the preoperative lymphocyte-to-monocyte ratio (LMR), calculated as the lymphocyte count divided by the monocyte count. Lymphocyte and monocyte values were obtained from the most recent preoperative laboratory test. Frailty was assessed one day before surgery using the FRAIL scale, which comprises five domains: fatigue, resistance, ambulation, illnesses, and weight loss. Each item is scored as 0 or 1, yielding a total score ranging from 0 to 5, with higher scores indicating greater frailty. Based on the total score, patients were categorized as robust (0 points), pre-frail (1-2 points), or frail (3-5 points).
结局指标
主要结局
The primary outcome was the occurrence of postoperative delirium (POD).
时间窗: POD assessment was performed twice daily for up to seven consecutive postoperative days or until hospital discharge, whichever occurred first.
The primary outcome was the occurrence of POD, evaluated by trained researchers using the 3-Minute Diagnostic Interview for Confusion Assessment Method (3D-CAM).
次要结局
未报告次要终点
研究者
Yanhong Liu
Deputy Chief of administration, Anesthesiology
Chinese PLA General Hospital