The association between Monocyte‐to‐Lymphocyte ratio and postoperative delirium in ICU patients in cardiac surgery

• Published in: Journal of clinical laboratory analysis 2022-07, Vol.36 (7), p.e24553-n/a
• Main Authors: Su, Xunling, Wang, Jie, Lu, Xing
• Format: Article
• Language: English
• Subjects: Addictions; Age; Biomarkers; Blood platelets; Blood pressure; Cardiac arrhythmia; Comorbidity; Delirium; Disease; Drug addiction; Heart; Heart failure; Heart rate; Heart surgery; Hypertension; Inflammation; inflammatory markers; Intensive care; Laboratories; Length of stay; Lymphocytes; medical information Mart for intensive care‐III; Monocytes; monocyte‐to‐lymphocyte ratio; Neutrophils; Patients; Physiology; postoperative delirium; Psychosis; Regression analysis; Respiration; Risk factors; Vascular diseases; Vital signs
• ISSN: 0887-8013; 1098-2825
• DOI: 10.1002/jcla.24553

Objective To analyze the relationship between monocyte‐to‐lymphocyte ratio (MLR) and postoperative delirium (POD). Methods This cohort study was conducted in the Medical Information Mart for Intensive Care‐III (MIMIC‐III) version 1.4 database. MLR was measured according to the complete blood count. ICD‐9 was used to measure postoperative delirium. Multivariable logistic regression was utilized to examine the relationship between MLR and POD. Results Three thousand eight hundred sixty‐eight patients who had received cardiac surgery were retrospectively enrolled, including 2171 males and 1697 females, with a mean age of 63.9 ± 16.2 years. The univariate analysis suggested that high MLR (as a continuous variable) as associated with a 21% higher risk of POD (O R: 1.12, 95% CI, 1.02, 1.43, p = 0.0259), After adjustments for other confounding factors, gender, age, race, temperature, SBP, DBP, MAP, respiratory rate, SOFA, peripheral vascular disease, AG, psychoses, drug, and alcohol addiction, the results showed that high MLR (as a continuous variable) independently served as a risk factor for POD (OR: 1.21; 95% CI: 1.01–1.44; p = 0.0378). MLR was assessed as quintile and tertiles, high MLR was an independent risk factor for POD. In the subgroup analysis, there were no differences in MLR for patients with POD in pre‐specified subgroups. Conclusions Monocyte‐to‐lymphocyte ratio was a risk factor for POD. More research is necessary to thoroughly examine the function of MLR in POD. Delirium, which is defined as an acute confessional condition whose characteristics include impaired mental state, is correlated with significant economic costs, high incidence of falls and fall‐related accidents, self‐removal of medical equipment, long‐term hospitalizations, and even increased fatality rates. Our study observed that patients suffering from POD showed significantly higher MLR patients without POD. Another important finding is that elevated MLR level independently served as a risk factor to predict POD.