Glucose-to-Albumin Ratio as a New Predictive Indicator for Postoperative Delirium in Geriatric Hip Fracture Patients

Abstract

Background

Predicting postoperative delirium (POD) in patients who have hip fractures is challenging due to its complex mechanism. Therefore, there is a critical need to explore and evaluate a novel predictive indicator.

Methods

There were four hematological markers independently associated with POD that were utilized to construct and evaluate a more reliable predictive indicator for POD. The study employed random sampling, dividing the data into training and validation cohorts in a 7:3 ratio. The strength of association between each predictive indicator and POD was assessed using multivariable logistic analysis and propensity score matching analysis. Predictive indicators with significant correlations underwent receiver operating characteristic curve and characteristic parameter comparisons to identify the optimal predictive indicator. Subsequent validation included the assessment of discriminative ability, correlation, and predictive performance. Furthermore, subgroup analysis was conducted to explore potential interactions. A total of 1,807 patients were included in this study, with a POD incidence rate of 16.5%.

Results

Multivariable logistic analysis and propensity score matching analysis demonstrated that the glucose-to-albumin ratio (GAR) was independently positively associated with POD. Specifically, for every 0.1 unit increase in preoperative GAR levels in hip fracture patients, the risk of POD increased by 1.6 times. The receiver operating characteristic curve curve indicated that the optimal cutoff value for the GAR was 0.2, with an area under the curve of 0.8, sensitivity of 81.2%, and specificity of 59.0%.

Conclusions

Preoperative GAR has a certain predictive value for the occurrence of POD and can function as a novel indicator for predicting POD in geriatric hip fracture patients.