Predictive value of preoperative IL-17A and CAR combined detection for delirium in elderly patients after general anesthesia
Objective To analyze the predictive value of preoperative interleukin-17A(IL-17A) and C-reactive protein/albumin ratio(CAR)for postoperative delirium in elderly patients under general anesthesia. Methods A total of 283 elderly patients who underwent general anesthesia surgery at Beijing Tongzhou Maternal and Child Health Hospital from July 2022 to June 2023 were retrospectively analyzed. They were divided into two groups based on the occurrence of postoperative delirium:the delirium group(n=74) and the non-delirium group (n=209). The general data and preoperative laboratory indexes of both groups were collected. Univariate and multivariate logistic regression analysis were conducted to analyze the factors influencing delirium in elderly patients after general anesthesia. The receiver operating characteristic (ROC) curves were drawn to analyze the predictive efficacy of preoperative IL-17A and CAR combined detection for delirium after general anesthesia in elderly patients. Results There were significant differences in age,resuscitation time,intraoperative blood loss,ASA grade,alcohol history,sedative drug use,serum albumin,Hb, IL-17A,CRP and CAP levels between the elderly patients with delirium after general anesthesia and those without delirium(x2/t=2.134,3.535,6.608,8.944,4.679,11.097,5.786,2.086,6.409,17.066,13.946, P<0.05). Multivariate logistic regression analysis showed that age,intraoperative blood loss,sedative use or not,serum albumin,IL-17A,CRP and CAP levels were the influencing factors for delirium after general anesthesia in elderly patients(P<0.05). The ROC curve results showed that IL-17A,CAP and AUC were 0.871, 0.959 and 0.984(P<0.05). The sensitivity was 0.716,0.932 and 0.959,and the specificity was 0.837,0.880 and 0.943,respectively. Conclusion Preoperative levels of IL-17A and CAP affect the occurrence of delirium in elderly patients after general anesthesia. Both single and combined detection show good predictive efficacy for delirium in elderly patients after general anesthesia.
IL-17ACARElderly patientsDelirium after surgery under general anesthesia