谵妄
四分位数
入射(几何)
C反应蛋白
医学
置信区间
内科学
载脂蛋白E
混乱
相对风险
胃肠病学
炎症
心理学
重症监护医学
疾病
物理
光学
精神分析
作者
Sarinnapha Vasunilashorn,Long Ngo,Sharon K. Inouye,Tamara G. Fong,Richard N. Jones,Simon T. Dillon,Towia A. Libermann,Margaret O’Connor,Steven E. Arnold,Zhongcong Xie,Edward R. Marcantonio
标识
DOI:10.1016/j.jalz.2019.09.080
摘要
Abstract Introduction Apolipoprotein E (APOE) status may modify the risk of postoperative delirium conferred by inflammation. Methods We tested whether APOE modifies the established association between C‐reactive protein (CRP) and delirium incidence, severity, and duration in 553 noncardiac surgical patients aged 70 and older. High postoperative plasma CRP (≥234.12 mg/L) was defined by the highest sample‐based quartile. Delirium was determined using the Confusion Assessment Method and chart review, and severity was determined by the Confusion Assessment Method—Severity score. Results APOE ε4 carrier prevalence was 19%, and postoperative delirium occurred in 24%. The relationship between CRP and delirium incidence, severity, and duration differed by ε4 status. Among ε4 carriers, there was a strong relationship between high CRP (vs. low CRP) and delirium incidence (relative risk [95% confidence interval], 3.0 [1.4–6.7]); however, no significant association was observed among non‐ε4 carriers (relative risk [95% CI], 1.2 [0.8–1.7]). Discussion Our findings raise the possibility that APOE ε4 carrier status may modify the relationship between postoperative day 2 CRP levels and postoperative delirium.
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