The Association Between SIRI and POD in Older Patients

Study Overview
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Brief Summary
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Postoperative delirium (POD) remains one of most common complication in elderly patients receiving surgery, which is characterized by acute and fluctuating change in the level of cognition and consciousness. Previous studies have shown that surgery and anesthesia-induced acute peripheral inflammation and neuroinflammation may lead to delirium after surgery. Systemic Inflammation Response Index (SIRI) is a more easily accessible and comprehensive inflammation marker derived from monocyte, neutrophil, and lymphocyte count, which has been investigated to assess the prognosis of cancer and infectious diseases. However, the relationship between SIRI and POD has yet to be investigated.

Official Title
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The Potential Value of Systemic Inflammation Response Index on Postoperative Delirium in Older Patients

Conditions
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Elderly, Postoperative Delirium, Surgery

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Hospital stay of at least 3 days More than or equal to 65 years old Elementary education or above Able to communicate American Society of Anesthesiologists (ASA) physical status I-III Mini-mental State Examination (MMSE) scores ≥ 22 points Exclusion Criteria: Preoperative delirium Severe mental diseases Autoimmune-illness, chronic infectious diseases, nervous system diseases and malignancies

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| POD group<br>Patients were considered to surfer from postoperative delirium by a positive Confusion Assessment Method (CAM) questionnaire after surgery. | |
| No-POD group<br>Patients did not surfer from postoperative delirium by a positive CAM questionnaire after surgery. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Confusion assessment method (CAM) score | Positive CAM score means that the patient developed postoperative delirium. While negative CAM score means that the patient did not develop postoperative delirium. | Baseline (Before surgery) | 
| CAM score | Positive CAM score means that the patient developed postoperative delirium. While negative CAM score means that the patient did not develop postoperative delirium. | Postoperative day 1 | 
| CAM score | Positive CAM score means that the patient developed postoperative delirium. While negative CAM score means that the patient did not develop postoperative delirium. | Postoperative day 2 | 
| CAM score | Positive CAM score means that the patient developed postoperative delirium. While negative CAM score means that the patient did not develop postoperative delirium. | Postoperative day 3 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The level of systemic inflammation response index (SIRI) in peripheral blood. | The SIRI was calculated as neutrophil count × monocyte count/lymphocyte count. | Baseline (Before surgery) | 
| Mini-mental State Examination (MMSE) score | MMSE score ranges from 0 to 30 and higher score means better outcome. | Baseline (Before surgery) | 
| MMSE score | MMSE score ranges from 0 to 30 and higher score means better outcome. | postoperative day 1 | 
| MMSE score | MMSE score ranges from 0 to 30 and higher score means better outcome. | postoperative day 3 |