Differential Associations of Postoperative Plasma and Cerebrospinal Fluid Albumin Changes with Delirium Following Non-Cardiac Surgery

The study examined the relationship between changes in albumin levels in blood and cerebrospinal fluid after surgery and the development of postoperative delirium in older patients. Among 240 patients, postoperative delirium developed in 31 patients (13.3%). Albumin levels in plasma decreased from a median of 3.95 to 3.43 g/dL and in cerebrospinal fluid from 22.68 to 20.43 mg/dL. Greater decreases in plasma albumin were independently associated with postoperative delirium and longer hospital stay, whereas changes in cerebrospinal fluid albumin were not associated with delirium. The results suggest that plasma albumin decrease, rather than cerebrospinal fluid albumin changes, is the main factor associated with postoperative delirium.