Value Of C-reactive Protein/Albumin Ratio Predicts Postoperative Delirium In Elderly Patients After Laparoscopic Radical Resection Of Colorectal Cancer

Objective: To analyze the risk factors of POD in elderly patients undergoing laparoscopic radical resection of colorectal cancer,and to explore the predictive value of CAR levels before and after surgery for POD in elderly patients.Methods: From October 2018 to October 2019,177 patients(age ≥ 65 years)who underwent laparoscopic radical resection of colorectal cancer at the First Hospital of Jilin University were selected.American society of anesthesiologists(ASA)grades II-III.According to the confusion assessment method(CAM),assess whether the patient has POD within 7 days and divided into two groups,the POD group(n = 39)and the non-POD group(n = 138).The demographics,clinical data,and preoperative and postoperative laboratory tests were compared between the two groups.The univariate and multivariate logistic regression analysis was performed on the risk factors of POD,and the receiver operating characteristic(ROC)curve was drawn to evaluate the optimal critical value of CAR for POD.Results: There were 39 patients with POD on the 7th day after surgery,with an incidence of 22.03%(39/177).Preoperative CAR level and CRP level on the second day after surgery had certain predictive value for POD.The area under the curve(AUC)of the preoperative CAR was 0.868,the optimal cut-off value was 0.136,the sensitivity was 71.8%,and the specificity was 95.7%(95% CI: 0.790-0.946,P <0.000).The AUC of CRP on the second day after surgery was 0.668,the optimal cut-off value was 118.19 mg/L,the sensitivity corresponding to the cut point was 53.8%,and the specificity was 72.5%(95% CI: 0.576-0.760,P<0.001).Age(OR: 1.17,95% CI: 1.05-1.29,P = 0.003),preoperative CAR level(OR: 1.35,95% CI: 1.15-1.58,P = 0.000)and CRP level on the second day after surgery(OR : 1.06,95% CI: 1.00-1.11,P = 0.036)were independent predictive factors for POD in elderly patients after laparoscopic radical resection of colorectal cancer.Conclusion: Age,preoperative CAR level and CRP level on the second day after surgery may be effective predictors of POD in elderly patients after laparoscopic radical resection of colorectal cancer.