Correlation between complete blood count-derived inflammatory markers and sepsis-associated delirium in older patients: a retrospective analysis of the MIMIC-IV database

作者：Lu Wang, Zhongmin Tian, Lei Zuo, Yunlong He, Yanjun Liu, Haitao Liu · 发表于：BMJ Open · 年份：2025 · DOI：10.1136/bmjopen-2025-101960 · 被引用次数：5 · 研究领域：Sepsis Diagnosis and Treatment、Inflammation biomarkers and pathways、Intensive Care Unit Cognitive Disorders

OBJECTIVES: To assess the correlation between complete blood count (CBC)-derived inflammatory markers and sepsis-associated delirium (SAD) risk in older intensive care unit (ICU) patients. DESIGN: Retrospective cohort study. SETTING: ICUs at Beth Israel Deaconess Medical Center (2008-2019), using the Medical Information Mart for Intensive Care IV V.3.0 database. PARTICIPANTS: 3412 critically ill patients aged ≥65 years with sepsis. EXCLUSION: repeated ICU admission, death/discharge within 24 hours, missing delirium assessment or pre-sepsis delirium from non-septic aetiologies. SAD was diagnosed by Confusion Assessment Method for the ICU. PRIMARY OUTCOME MEASURE: Incidence of sepsis-associated delirium. RESULTS: Among 3412 older sepsis patients, 2092 (61.3%) developed SAD. Significant differences in platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index, systemic inflammation response index, pan-immune-inflammation value and neutrophil-monocyte-to-lymphocyte ratio were observed between SAD and non-SAD groups (all p<0.001). After multivariable adjustment, elevated levels of these markers were associated with increased SAD risk, with MLR showing the strongest association (Q4 vs Q1 adjusted OR=2.66, 95% CI 2.14 to 3.30). Restricted cubic spline analysis revealed non-linear associations between inflammatory marker levels and SAD risk (p for non-linear <0.001). The results of most subgroup analyses were c...