Value of preoperative triglyceride to high-density lipoprotein cholesterol ratio in predicting postoperative delirium following internal fixation for lower limb fracture in geriatric patients
10.3760/cma.j.cn131073-20250324-01108
- VernacularTitle:术前TG/HDL-C比值预测下肢骨折复位内固定术老年患者POD发生的价值
- Author:
Hongyu ZUO
1
;
Meinyu LIU
1
;
Jing WANG
1
;
Jianli LI
1
Author Information
1. 河北省人民医院麻醉科，石家庄 050051
- Publication Type:Journal Article
- Keywords:
Triglycerides;
Cholesterol, HDL;
Delirious speech;
Postoperative complications;
Aged
- From:
Chinese Journal of Anesthesiology
2025;45(11):1427-1432
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the value of preoperative triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio in predicting postoperative delirium (POD) following internal fixation for lower limb fracture in geriatric patients.Methods:In this retrospective case-control study, the medical records of patients, aged ≥ 65 yr, with American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, who underwent internal fixation for lower limb fracture under general anesthesia or spinal-epidural anes-thesia at Hebei General Hospital from January 2023 to July 2024, with the postoperative length of hospital stay of at least 3 days, were collected. The baseline characteristics, preoperative length of hospital stay, parameters of the last preoperative laboratory tests, type of surgery, anesthesia method, duration of surgery and anesthesia, and intraoperative hypotension and fluid intake and output were collected, and the ratio of TG to HDL-C was calculated. Patients were stratified into POD group and non-POD group based on whether POD developed. The logistic regression was carried out to identify influencing factors for POD. The receiver operating characteristic (ROC) curve was plotted to evaluate the predictive accuracy of preoperative TG/HDL-C ratio in predicting POD.Results:A total of 234 patients were finally included, of whom 30 developed POD, with an incidence of 12.8%. The results of multivariate logistic regression indicated that the elevated preoperative TG/HDL-C ratio, increased WBC count and a history of cerebrovascular disease were independent risk factors for POD, and the increased albumin concentration was an independent protective factor for POD ( P<0.05). The area under the curve of preoperative TG/HDL-C ratio in predicting POD was 0.758, with a specificity of 0.809 and sensitivity of 0.633, and the optimal cut-off value was 3.285 ( P<0.001). Conclusions:Elevated preoperative TG/HDL-C ratio is an independent risk factor for POD and may have a certain predictive value for POD in geriatric patients undergoing internal fixation for lower limb fracture.
