Preoperative Lymphocyte-to-Monocyte Ratio and Postoperative Delirium by Frailty Status in Older Surgical Patients

Chinese PLA General Hospital (301 Hospital)

Status: Completed

Conditions: Postoperative Delirium (POD); Lymphocyte; Frailty at Older Adults

Study type: Observational

Funder types: Other

Identifiers

NCT07322744

LMR - POD

Details and patient eligibility

About

Both frailty and a reduced preoperative lymphocyte-to-monocyte ratio (LMR) are known risk factors for postoperative delirium (POD). However, whether the relationship between LMR and POD varies by frailty status remains unclear. This study aimed to evaluate the frailty-stratified association between preoperative LMR and POD in older surgical patients.

Enrollment: 6,475 patients

Sex: All

Ages: 65+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Aged ≥65 years;
• Underwent elective noncardiac, nonneurosurgical procedures;
• Completed the preoperative health and functional status questionnaire.

Exclusion criteria

• Severe dementia, language disorders, significant hearing or visual impairments, or coma;
• Cognitive function below the Mini-Mental State Examination thresholds (<18 for illiterate individuals, <21 for individuals with primary education, and <25 for individuals with secondary education or higher);
• Surgery performed under local anesthesia or monitored anesthesia care;
• Missing lymphocyte or monocyte count data;
• Missing postoperative delirium assessment;
• Incomplete preoperative FRAIL scale evaluation;
• Missing data for more than 20% of covariates.

Trial design

6,475 participants in 1 patient group

A retrospective cohort study based on prospectively collected data.

Description:

Patients were grouped according to the preoperative lymphocyte-to-monocyte ratio (LMR), calculated as the lymphocyte count divided by the monocyte count. Lymphocyte and monocyte values were obtained from the most recent preoperative laboratory test. Frailty was assessed one day before surgery using the FRAIL scale, which comprises five domains: fatigue, resistance, ambulation, illnesses, and weight loss. Each item is scored as 0 or 1, yielding a total score ranging from 0 to 5, with higher scores indicating greater frailty. Based on the total score, patients were categorized as robust (0 points), pre-frail (1-2 points), or frail (3-5 points).