Clinical study of the lymphocyte-associated inflammation score in predicting the risk of postoperative cognitive dysfunction after hip fracture in the elderly
Objective To assess the risk of postoperative cognitive dysfunction(POCD)in elderly hip fracture patients by constructing the Lymphocyte-Associated Inflammation Score(LAIS)based on Neutrophil to lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR),and monocyte-lymphocyte ratio(MLR).Methods In a retrospective analysis of 181 elderly hip fracture patients treated in our hospital from June 1,2020,to June 30,2023,NLR,PLR and MLR of patients were collected preoperatively,and LAIS was constructed based on the joint receiver operating characteristic(ROC)curve.A multivariate logistic regression model was used to analyze the risk factors of elderly hip fracture patients,and the ROC curve was used for performance assessment.Results Among 181 elderly hip fracture patients,the incidence of POCD was 21.5%(39/181).The NLR,PLR and MLR were higher in patients with POCD than in those without POCD(P<0.05).The results of ROC curve analysis showed that the AUC of NLR,PLR and MLR were 0.765(0.696-0.825),0.761(0.692-0.821)and 0.773(0.705-0.832),with optimal cut-off values of>2.62,>168.62 and>0.47,respectively.The results of multifactorial logistic regression analysis showed that age(OR:2.100,95%CI:1.141-1.268),diabetes mellitus(OR:2.125,95%CI:1.055-4.412),ASA score(3)(OR:2.230,95%CI:1.071-4.231),TNF-α(OR:2.227,95%CI:1.005-3.552),and LAIS(OR:2.954,95%CI:1.567-4.652)were the POCD in elderly patients with hip fracture independent risk factors(P<0.05).The results of ROC curve analysis showed that the AUCs for age,diabetes mellitus,ASA score,TNF-α and LAIS were 0.604(0.529-0.676),0.639(0.565-0.709),0.619(0.544-0.690),0.782(0.714-0.840)and 0.847(0.786-0.896).Conclusions The incidence of POCD in elderly hip fractures is high.LAIS could provide a reliable preoperative assessment for the risk of POCD,improving the perioperative diagnosis and treatment plan and reducing the risk of POCD.
万方数据
维普
