{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T18:27:31Z","timestamp":1788546451264,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Emergence agitation (EA) is a postoperative neurobehavioral complication characterized by a transient disturbance in cognition and perception following anesthesia. Neuroinflammation is thought to play a central role in its pathophysiology. Preoperative anxiety is the \u201cacute preoperative stress response.\u201d This study aimed to evaluate the relationship between hemogram\u2010derived inflammatory markers and the development of preoperative anxiety and EA in pediatric patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective observational study included 350 pediatric patients aged 5\u201312\u2009years with ASA grade I\u2010II. Preoperative anxiety was assessed in the waiting room using the modified Yale Preoperative Anxiety Scale. Demographic and clinical data, anesthesia\/surgical data, and hemogram parameters were recorded. EA was evaluated in the recovery room using the Pediatric Anesthesia Emergence Delirium scale. Pain was assessed at 0, 5, 10, 20, and 30\u2009min using the FLACC scale in children &lt;\u20097\u2009years and the Visual Analog Scale in those \u2265\u20097\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the total 350 patients, 130 (37.1%) developed EA. Compared with those without EA, children with EA had significantly higher leukocyte, monocyte, neutrophil, and platelet counts (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018, 0.005, 0.001, and 0.001, respectively), lower lymphocyte counts (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.042), and elevated monocyte\u2010to\u2010lymphocyte ratio, neutrophil\u2010to\u2010lymphocyte ratio, platelet\u2010to\u2010lymphocyte ratio, and systemic immune inflammatory index (SII) (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Regression analysis showed that younger age, higher postoperative pain scores, and elevated SII were independently associated with EA. Preoperative anxiety was observed in 103 children (29.4%). These patients had higher white blood cell counts (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026), and regression analysis identified that younger age, anxious parents, and elevated SII were independently associated with preoperative anxiety.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Easily obtainable hemogram\u2010derived inflammatory markers, particularly SII, may be useful for identifying children at increased risk of preoperative anxiety and EA in children. These findings suggest that SII may assist anesthesiologists in identifying high\u2010risk patients and implementing preventive strategies to reduce the incidence of EA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      The study was registered at\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      (NCT06648122)\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pan.70246","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T08:10:24Z","timestamp":1781770224000},"page":"1132-1142","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Association of Preoperative Inflammatory Markers With Preoperative Anxiety and Emergence Agitation in Children"],"prefix":"10.1002","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6758-2849","authenticated-orcid":false,"given":"Nezahat Merve Ata","family":"Soylu","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Faculty of Medicine Cukurova University  Adana T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7581-5966","authenticated-orcid":false,"given":"Zehra","family":"Hatipoglu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Faculty of Medicine Cukurova University  Adana T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8415-8571","authenticated-orcid":false,"given":"Ersel","family":"Gulec","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Faculty of Medicine Cukurova University  Adana T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7378-6265","authenticated-orcid":false,"given":"Mediha","family":"Turktan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Faculty of Medicine Cukurova University  Adana T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3898-9375","authenticated-orcid":false,"given":"Nurefsan","family":"Sad\u0131koglu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Faculty of Medicine Cukurova University  Adana T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1308-8569","authenticated-orcid":false,"given":"Yusuf Kemal","family":"Arslan","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Faculty of Medicine Cukurova University  Adana T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2598-0127","authenticated-orcid":false,"given":"Dilek","family":"Ozcengiz","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Faculty of Medicine Cukurova University  Adana T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.4103\/njcp.njcp_227_17"},{"issue":"3","key":"e_1_2_11_3_1","first-page":"730","article-title":"Validity and Reliability of the Turkish Version of the Modified Yale Preoperative Anxiety Scale","volume":"49","author":"Hatipoglu Z.","year":"2019","journal-title":"Turkish Journal of Medical Sciences"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.4097\/kja.20097"},{"key":"e_1_2_11_5_1","first-page":"1","article-title":"Preoperative Anxiety and 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