Association Between Fibrinogen-to-albumin Ratio and Delirium After Deep Brain Stimulation Surgery in Parkinson's Disease

Study Overview
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Brief Summary
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Postoperative delirium (POD) remains one of the most common neuropsychiatric complications after deep brain stimulation (DBS) surgery. The fibrinogen-to-albumin ratio (FAR) has been shown to significantly correlate with prognosis of many diseases associated with inflammation, but the relationship between FAR and POD is unclear. The investigators aimed to investigate the association between POD and FAR in Parkinson's disease (PD) patients receiving DBS surgery. For this aim, the present study was conducted to provide a new method for the early recognition and perioperative management of delirium after DBS surgery in PD patients.

Official Title
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Association Between Fibrinogen-to-albumin Ratio and Delirium After Deep Brain Stimulation Surgery in Parkinson's Disease

Conditions
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Parkinson Disease, Deep Brain Stimulation, Postoperative Delirium

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Over 55 years old American Society of Anesthesiologists (ASA) physical status I-III Bilateral subthalamic nucleus deep brain stimulation surgery Exclusion Criteria: Preoperative delirium Missing preoperative laboratory parameters on fibrinogen or albumin Persistent infectious diseases Coagulopathy and autoimmune-illness or malignancies

Ages Eligible for Study
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Minimum Age: 55 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 who were determined to have incident postoperative delirium by a positive confusion assessment method (CAM) questionnaire after operation were defined as the POD group. | |
| Non-POD group<br>Patients who did not suffer from delirium after surgery consisted of the Non-POD group. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| CAM score | Positive CAM score means that patient developed delirium after surgery. While negative CAM score means that patient did not suffer from delirium after surgery. | Before surgery | 
| CAM score | Positive CAM score means that patient developed delirium after surgery. While negative CAM score means that patient did not suffer from delirium after surgery. | Postoperative day 1 | 
| CAM score | Positive CAM score means that patient developed delirium after surgery. While negative CAM score means that patient did not suffer from delirium after surgery. | Postoperative day 2 | 
| CAM score | Positive CAM score means that patient developed delirium after surgery. While negative CAM score means that patient did not suffer from delirium after surgery. | Postoperative day 3 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mini-mental State Examination (MMSE) score | MMSE score ranges from 0 to 30 and higher score means better cognitive function. | Before surgery | 
| MMSE score | MMSE score ranges from 0 to 30 and higher score means better cognitive function. | Postoperative 24 hour | 
| MMSE score | MMSE score ranges from 0 to 30 and higher score means better cognitive function. | postoperative 72 hour | 
| The level of fibrinogen-to-albumin ratio (FAR) in peripheral blood. | The FAR was calculated as fibrinogen / albumin. | Before surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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postoperative delirium, fibrinogen-to-albumin ratio