Neutrophil-Lymphocyte Ratio as a Potential Biomarker for Delirium in the Intensive Care Unit

Background: Recognition and early detection of delirium in the intensive care unit (ICU) is essential to improve ICU outcomes. To date, neutrophil-lymphocyte ratio (NLR), one of inflammatory markers, has been proposed as a potential biomarker for brain disorders related to neuroinflammation. This st...

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Autores principales:	Chai Lee Seo, Jin Young Park, Jaesub Park, Hesun Erin Kim, Jaehwa Cho, Jeong-Ho Seok, Jae-Jin Kim, Cheung Soo Shin, Jooyoung Oh
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	delirium neutrophil-lymphocyte ratio C-reactive protein intensive care unit inflammatory markers Psychiatry RC435-571
Acceso en línea:	https://doaj.org/article/8be1be95d4774b029230c74fd1b54efc
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spelling	oai:doaj.org-article:8be1be95d4774b029230c74fd1b54efc2021-12-01T13:29:01ZNeutrophil-Lymphocyte Ratio as a Potential Biomarker for Delirium in the Intensive Care Unit1664-064010.3389/fpsyt.2021.729421https://doaj.org/article/8be1be95d4774b029230c74fd1b54efc2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fpsyt.2021.729421/fullhttps://doaj.org/toc/1664-0640Background: Recognition and early detection of delirium in the intensive care unit (ICU) is essential to improve ICU outcomes. To date, neutrophil-lymphocyte ratio (NLR), one of inflammatory markers, has been proposed as a potential biomarker for brain disorders related to neuroinflammation. This study aimed to investigate whether NLR could be utilized in early detection of delirium in the ICU.Methods: Of 10,144 patients who admitted to the ICU, 1,112 delirium patients (DE) were included in the current study. To compare among inflammatory markers, NLR, C-reactive protein (CRP), and white blood cell (WBC) counts were obtained: the mean NLR, CRP levels, and WBC counts between the initial day of ICU admission and the day of initial delirium onset within DE were examined. The inflammatory marker of 1,272 non-delirium patients (ND) were also comparatively measured as a supplement. Further comparisons included a subgroup analysis based on delirium subtypes (non-hypoactive vs. hypoactive) or admission types (elective vs. emergent).Results: The NLR and CRP levels in DE increased on the day of delirium onset compared to the initial admission day. ND also showed increased CRP levels on the sixth day (the closest day to average delirium onset day among DE) of ICU admission compared to baseline, while NLR in ND did not show significant difference over time. In further analyses, the CRP level of the non-hypoactive group was more increased than that of the hypoactive group during the delirium onset. NLR, however, was more significantly increased in patients with elective admission than in those with emergent admission.Conclusion: Elevation of NLR was more closely linked to the onset of delirium compared to other inflammatory markers, indicating that NLR may play a role in early detection of delirium.Chai Lee SeoJin Young ParkJin Young ParkJaesub ParkJaesub ParkHesun Erin KimJaehwa ChoJeong-Ho SeokJeong-Ho SeokJae-Jin KimJae-Jin KimCheung Soo ShinJooyoung OhJooyoung OhFrontiers Media S.A.articledeliriumneutrophil-lymphocyte ratioC-reactive proteinintensive care unitinflammatory markersPsychiatryRC435-571ENFrontiers in Psychiatry, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	delirium neutrophil-lymphocyte ratio C-reactive protein intensive care unit inflammatory markers Psychiatry RC435-571
spellingShingle	delirium neutrophil-lymphocyte ratio C-reactive protein intensive care unit inflammatory markers Psychiatry RC435-571 Chai Lee Seo Jin Young Park Jin Young Park Jaesub Park Jaesub Park Hesun Erin Kim Jaehwa Cho Jeong-Ho Seok Jeong-Ho Seok Jae-Jin Kim Jae-Jin Kim Cheung Soo Shin Jooyoung Oh Jooyoung Oh Neutrophil-Lymphocyte Ratio as a Potential Biomarker for Delirium in the Intensive Care Unit
description	Background: Recognition and early detection of delirium in the intensive care unit (ICU) is essential to improve ICU outcomes. To date, neutrophil-lymphocyte ratio (NLR), one of inflammatory markers, has been proposed as a potential biomarker for brain disorders related to neuroinflammation. This study aimed to investigate whether NLR could be utilized in early detection of delirium in the ICU.Methods: Of 10,144 patients who admitted to the ICU, 1,112 delirium patients (DE) were included in the current study. To compare among inflammatory markers, NLR, C-reactive protein (CRP), and white blood cell (WBC) counts were obtained: the mean NLR, CRP levels, and WBC counts between the initial day of ICU admission and the day of initial delirium onset within DE were examined. The inflammatory marker of 1,272 non-delirium patients (ND) were also comparatively measured as a supplement. Further comparisons included a subgroup analysis based on delirium subtypes (non-hypoactive vs. hypoactive) or admission types (elective vs. emergent).Results: The NLR and CRP levels in DE increased on the day of delirium onset compared to the initial admission day. ND also showed increased CRP levels on the sixth day (the closest day to average delirium onset day among DE) of ICU admission compared to baseline, while NLR in ND did not show significant difference over time. In further analyses, the CRP level of the non-hypoactive group was more increased than that of the hypoactive group during the delirium onset. NLR, however, was more significantly increased in patients with elective admission than in those with emergent admission.Conclusion: Elevation of NLR was more closely linked to the onset of delirium compared to other inflammatory markers, indicating that NLR may play a role in early detection of delirium.
format	article
author	Chai Lee Seo Jin Young Park Jin Young Park Jaesub Park Jaesub Park Hesun Erin Kim Jaehwa Cho Jeong-Ho Seok Jeong-Ho Seok Jae-Jin Kim Jae-Jin Kim Cheung Soo Shin Jooyoung Oh Jooyoung Oh
author_facet	Chai Lee Seo Jin Young Park Jin Young Park Jaesub Park Jaesub Park Hesun Erin Kim Jaehwa Cho Jeong-Ho Seok Jeong-Ho Seok Jae-Jin Kim Jae-Jin Kim Cheung Soo Shin Jooyoung Oh Jooyoung Oh
author_sort	Chai Lee Seo
title	Neutrophil-Lymphocyte Ratio as a Potential Biomarker for Delirium in the Intensive Care Unit
title_short	Neutrophil-Lymphocyte Ratio as a Potential Biomarker for Delirium in the Intensive Care Unit
title_full	Neutrophil-Lymphocyte Ratio as a Potential Biomarker for Delirium in the Intensive Care Unit
title_fullStr	Neutrophil-Lymphocyte Ratio as a Potential Biomarker for Delirium in the Intensive Care Unit
title_full_unstemmed	Neutrophil-Lymphocyte Ratio as a Potential Biomarker for Delirium in the Intensive Care Unit
title_sort	neutrophil-lymphocyte ratio as a potential biomarker for delirium in the intensive care unit
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/8be1be95d4774b029230c74fd1b54efc
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Neutrophil-Lymphocyte Ratio as a Potential Biomarker for Delirium in the Intensive Care Unit

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