High CRP Before and After Surgery Linked to Delirium

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The researchers found that postoperative delirium occurred in 24% of participants and that 12% had 2 or more delirium days.
The researchers found that postoperative delirium occurred in 24% of participants and that 12% had 2 or more delirium days.

(HealthDay News) — For older adults undergoing major noncardiac surgery, preoperative and postoperative day 2 (POD2) C-reactive protein (CRP) levels are associated with the incidence, duration, and severity of delirium, according to a study published online in the Journal of the American Geriatrics Society.

Sarinnapha M. Vasunilashorn, PhD, from the Beth Israel Deaconess Medical Center in Boston, and colleagues conducted a prospective cohort study involving 560 adults aged 70 years and older undergoing major noncardiac surgery. They examined the correlation between CRP measured preoperatively and on POD2 and the incidence, duration, and feature severity of delirium.

The researchers found that postoperative delirium occurred in 24% of participants and that 12% had 2 or more delirium days. Compared with those with a preoperative CRP <3 mg/L, participants with preoperative CRP ≥3 mg/L had a 1.5-fold increased risk of delirium, 0.4 more delirium days, more severe delirium, and a 1.4-fold risk of prolonged length of stay after adjustment for age, sex, surgery type, anesthesia route, medical comorbidities, and postoperative infectious complications. Participants in the highest quartile of CRP POD2 were 1.5-fold more likely to develop delirium, had 0.2 more delirium days, and had more severe delirium compared with those in the lowest quartile.

"CRP may be useful to identify individuals who are at risk of developing delirium," the authors write.

Reference

  1. Vasunilashorn SM, Dillon ST, Inouye SK, et al. High C-Reactive Protein Predicts Delirium Incidence, Duration, and Feature Severity After Major Noncardiac Surgery.  J Am Geriatr Soc. 26 May 2017. doi: 10.1111/jgs.14913
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