Evaluation of the Efficiency of Neutrophil-Lymphocyte Ratio in Predicting Delirium in Geriatric Patients Undergoing Hip Fracture Surgery

NCT07741175 | Completed

• 1 other identifier: 2022-02/1680
• Study Type: observational
• Target: 100
• Locations: 1 country
• Sites: 2

Brief Summary

Aim: Postoperative delirium (POD) is one of the most common complications in elderly patients and is associated with increased morbidity, mortality, length of hospital stay and medical care costs. One of the mechanisms proposed for the pathophysiology of delirium is neuroinflammatory processes. The neutrophil-lymphocyte ratio (NLR) is a cost-effective and easily applicable marker of inflammation and oxidative stress. NLR has been used to predict complications, determine prognosis and evaluate mortality in various patient groups and diseases. Most of the studies investigating the relationship between NLR and postoperative delirium in the elderly patient group undergoing hip fracture surgery are retrospective, and the number of prospective studies with large case-series is insufficient. In this study, the investigators aimed to evaluate the effectiveness of NLR in predicting postoperative delirium in elderly patients undergoing hip fracture surgery.

Conditions

Elderly Patient; Hip Fracture Surgery; Delirium; Neutrophil Lymphocyte Ratio

Outcome Measures

Primary Outcomes (1)

• Postoperative Delirium Incidence

  Incidence and clinical features of postoperative delirium evaluated using the Confusion Assessment Method (CAM) algorithm. The CAM algorithm assesses four domain features: 1) acute onset and fluctuating course, 2) inattention, 3) disorganized thinking, and 4) altered level of consciousness. A diagnosis of delirium requires the presence of features 1 and 2, plus either feature 3 or 4

  Twice daily during the first 3 postoperative days

Secondary Outcomes (2)

• Neutrophil-to-Lymphocyte Ratio (NLR) Changes

  Baseline (preoperative), and at 1 hour, 16 hours, and 24 hours postoperatively first day

• Preoperative Cognitive Function

  Baseline (preoperative evaluation)

Study Arms (1)

Patients

Patients aged 65 and over, with a Mini Mental Test (MMT) score of 24 and above, who would undergo hip fracture surgery, who -or their legal guardian- could give voluntary consent, with ASA scores of I-IV.

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Patients aged 65 and over, with a Mini Mental Test (MMT) score of 24 and above, who would undergo hip fracture surgery, who -or their legal guardian- could give voluntary consent, with ASA scores of I-IV.

You may qualify if:

• Patients aged 65 and over
• Patients who will undergo hip fracture surgery
• Patients who or their relatives can give voluntary consent
• ASA I-IV patients
• Patients with a Preoperative Mini Mental Test (MMT) score of 24 and above

You may not qualify if:

• Under 65 years old
• Patients who did not agree to participate in the study
• Unconscious
• Patients with a preoperative Mini Mental Test (MMT) score below 24
• Visually, hearing and speech impaired
• Chronic alcohol user
• Patients with cognitive or psychiatric disorders such as known dementia, Parkinson's, Alzheimer's
• Patients who need postoperative mechanical ventilation support
• A history of acute myocardial infarction in the last 6 months
• Patients with chronic renal failure undergoing regular dialysis
• Patients using oxygen concentrators at home

Sponsors & Collaborators

• Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital: lead

Study Sites (2)

Ali Emre Karakis

Ankara, 06200, Turkey (Türkiye)

Location

Dr. Abdurrahman Yurtaslan OTRH

Ankara, Turkey (Türkiye)

Location

Related Publications (1)

• He R, Wang F, Shen H, Zeng Y, LijuanZhang. Association between increased neutrophil-to-lymphocyte ratio and postoperative delirium in elderly patients with total hip arthroplasty for hip fracture. BMC Psychiatry. 2020 Oct 7;20(1):496. doi: 10.1186/s12888-020-02908-2.

  PMID: 33028273 RESULT

MeSH Terms

Conditions

Delirium

Condition Hierarchy (Ancestors)

Confusion; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Neurocognitive Disorders; Mental Disorders

Study Officials

• Dilek Kalayci

  Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital

  STUDY DIRECTOR

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: March 29, 2023
• First Posted: August 3, 2026
• Study Start: February 24, 2022
• Primary Completion: October 27, 2022
• Study Completion: October 27, 2022
• Last Updated: August 3, 2026

Record last verified: 2026-07

Locations

TU (2)