Relationship between cerebrospinal fluid albumin/serum albumin ratio and systemic immunoinflammatory index and postoperative delirium in elderly patients with general anesthesia combined with epidural anesthesia
10.3969/j.issn.1673-4130.2025.12.011
- VernacularTitle:脑脊液白蛋白/血清白蛋白、系统性免疫炎症指数与全身麻醉联合硬膜外麻醉老年患者术后谵妄的关系
- Author:
Yanyan FAN
1
;
Huanhuan PAN
;
Zhenying LEI
Author Information
1. 开封市第三人民医院/开封市祥符区第一人民医院麻醉科,河南开封 475100
- Keywords:
cerebrospinal fluid;
serum albumin;
systemic immune inflammation index;
delirium;
elderly
- From:
International Journal of Laboratory Medicine
2025;46(12):1467-1471,1478
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the relationship between cerebrospinal fluid albumin/serum albumin(C-ALB/S-Alb)and the systemic immune inflammatory index(SII)and postoperative delirium(POD)in elderly patients with general anesthesia combined with epidural anesthesia.Methods Elderly patients who un-derwent elective hip replacement surgery and received general anesthesia combined with epidural anesthesia in this hospital from October 2023 to June 2024 were selected.According to the assessment results of the Chi-nese version of the 3-Minute Delirium Diagnostic Scale(3D-CAM),the patients were divided into the POD group(68 cases)and the non-POD group(76 cases).The general information of the patients was collected,the cerebrospinal fluid and venous blood specimens were detected.The levels of cerebrospinal fluid albumin(C-Alb),serum albumin(S-Alb),α-synuclein(α-syn),β-amyloid protein(Aβ)1-42,Aβ1-40,total Tau protein(t-Tau),phosphorylated Tau protein(p-Tau)were detected by enzyme-linked immunosorbent assay(ELISA).The neutrophil count,platelet count and lymphocyte count of the patients were detected by the fully automatic blood analyzer,and the SII was calculated.Results Compared with the non-POD group,the levels of C-Alb,α-syn,t-Tau,p-tau,SII and C-Alb/S-Alb in the POD group increased,while Aβ1-42 and Aβ1-40 were significantly decreased,and the differences were statistically significant(P＜0.05).C-Alb,t-Tau,SII and C-Alb/S-Alb were all independent risk factors for the occurrence of POD.The results of the receiver operating characteristic(ROC)curve analysis showed that the areas under the curve(AUC)of the ROC curves of SII,t-Tau,C-Alb,C-Alb/S-Alb and C-Alb/S-Alb combined with SII for predicting delirium were 0.824,0.818,0.723,0.862 and 0.926,respectively.The AUC predicted by C-Alb/S-Alb combined with SII was the highest(all P＜0.05).Conclusion High SII and C-Alb/S-Alb are independent risk factors for POD occurrence in eld-erly patients with general anesthesia combined with epidural anesthesia.Both have good predictive efficacy for POD,and the combined use has better predictive efficacy.
