Preoperative severe hypoalbuminemia is associated with an increased risk of postoperative delirium in elderly patients: Results of a secondary analysis

To explore the association between the severity of preoperative hypoalbuminemia and the occurrence of postoperative delirium. This was a secondary analysis of the database from a previously conducted clinical trial. 700 elderly patients (age ≥ 65 years) who were admitted to intensive care unit (ICU) after noncardiac surgery were included. Delirium was assessed with the Confusion Assessment Method for the ICU twice daily during the first 7 days postoperatively. Other outcomes were also monitored. The relationship between preoperative albumin level and postoperative delirium were analyzed using a logistic regression model. 111 of 700 patients (15.9%) developed postoperative delirium. When compared with normal albumin level (> 40.0 g/L), severe (≤ 30.0 g/L: OR 2.727, 95% CI 1.283–5.797, P = 0.009), but not mild (35.1–40.0 g/L: OR 1.175, 95% CI 0.679–2.032, P = 0.565) or moderate (30.1–35.0 g/L: OR 1.674, 95% CI 0.897–3.122, P = 0.105) hypoalbuminemia was associated with an increased risk of postoperative delirium. Preoperative severe hypoalbuminemia was also associated with prolonged mechanical ventilation, increased non-delirium complications, and prolonged ICU and hospital stay after surgery. Preoperative severe hypoalbuminemia (≤ 30.0 g/L) was associated with an increased risk of postoperative delirium and worse outcomes. Chinese Clinical Trial Registry, www.chictr.org.cn, ChiCTR-TRC-10000802.