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C-reactive protein for risk prediction of postoperative delirium and postoperative neurocognitive disorder

Acta Anaesthesiologica Scandinavica Dec 12, 2019

Knaak C, Vorderwülbecke G, Spies C, et al. – Because the presence of inflammation prior to surgery might predispose patients to postoperative delirium (POD) and postoperative neurocognitive disorder (NCD) development, researchers examined links between preoperative C-reactive protein (CRP) and the incidence of POD and postoperative NCD via performing an observational analysis including 314 patients registered in the SuDoCo trial. Participants had preoperative CRP levels measured the day before surgery. The primary outcomes included POD evaluated according to DSM-4 criteria from day 1 until day 7 following surgery, and postoperative NCD evaluated 3 months post-surgery. The investigators noted an independent link between preoperative CRP levels with POD but not with postoperative NCD after 3 months. Moreover, higher risk for POD was demonstrated by higher preoperative CRP levels—reinforcing the role of inflammation in POD development. Risk stratification of POD might thus be enabled by the evaluation of CRP prior to surgery.

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