{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T11:02:25Z","timestamp":1785841345610,"version":"3.56.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2020,10,11]],"date-time":"2020-10-11T00:00:00Z","timestamp":1602374400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Wuxi Municipal Commission Fund of Health and Family Planning","award":["MS201713"],"award-info":[{"award-number":["MS201713"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Studies have provided some evidence that pain is a risk factor for postoperative delirium (POD). Therefore, we investigated the relationship between preoperative pain and POD after noncardiac surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>POD was assessed with the Montreal Cognitive Assessment, and preoperative cognition was assessed with the Mini-Mental State Examination. Plasma C-reactive protein (CRP) was detected by enzyme-linked immunosorbent assay before surgery. Preoperative pain was classified by its duration before surgery as chronic pain (lasting more than 1\u2009month), acute pain (lasting less than 1\u2009month), or no pain (no obvious pain). Multiple linear regression was used to adjust for confounding.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>From October 15, 2018, through August 12, 2019, a total of 67 patients were randomized; 7 were excluded because they were discharged before the seventh postoperative day. The prevalence of POD was significantly higher in the acute pain group (13 of 20; 65%) than in the chronic pain group (5 of 20; 25%) or the no pain group (6 of 20; 30%) (P\u2009=\u20090.019), indicating that delirium is associated with preoperative acute pain. The plasma level of preoperative CRP was also higher in the acute pain group than in the other two groups (mean [interquartile range]: 10.7 [3.3, 29.3] vs 1 [0.5, 3.8]mg\/l; P\u2009&amp;lt;\u20090.001), suggesting that elevated preoperative plasma levels of CRP were associated with delirium.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Preoperative acute pain was associated with POD, and increased plasma levels of CRP provide a marker. In addition, we found that illiteracy and advanced age were risk factors for POD.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/pm\/pnaa314","type":"journal-article","created":{"date-parts":[[2020,9,5]],"date-time":"2020-09-05T19:10:26Z","timestamp":1599333026000},"page":"15-21","source":"Crossref","is-referenced-by-count":32,"title":["Preoperative Acute Pain Is Associated with Postoperative Delirium"],"prefix":"10.1093","volume":"22","author":[{"given":"Xian","family":"Ding","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, The Affiliated Hospital of Jiangnan University (Original Department at Wuxi Third People\u2019s Hospital), Wuxi, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Gao","sequence":"additional","affiliation":[{"name":"Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qizhong","family":"Chen","sequence":"additional","affiliation":[{"name":"Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuliang","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Li","sequence":"additional","affiliation":[{"name":"Math and Statistics School of Nanjing Audit University, Nanjing, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingjing","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Wuxi People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guowei","family":"Qin","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Wuxi People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunmei","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Wuxi People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongxiao","family":"Huang","sequence":"additional","affiliation":[{"name":"The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,10,11]]},"reference":[{"issue":"11","key":"2021020418562009300_pnaa314-B1","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1056\/NEJMra052321","article-title":"Delirium in older persons","volume":"354","author":"Inouye","year":"2006","journal-title":"N Engl J Med"},{"issue":"7","key":"2021020418562009300_pnaa314-B2","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1097\/CCM.0000000000001622","article-title":"Dexmedetomidine for the treatment of hyperactive delirium refractory to haloperidol in nonintubated ICU patients: A nonrandomized controlled trial","volume":"44","author":"Carrasco","year":"2016","journal-title":"Crit Care Med"},{"issue":"4","key":"2021020418562009300_pnaa314-B3","doi-asserted-by":"crossref","first-page":"e53","DOI":"10.1016\/j.lpm.2018.03.012","article-title":"Postoperative delirium","volume":"47","author":"Rengel","year":"2018","journal-title":"Presse Med"},{"issue":"9920","key":"2021020418562009300_pnaa314-B4","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1016\/S0140-6736(13)60688-1","article-title":"Delirium in elderly people","volume":"383","author":"Inouye","year":"2014","journal-title":"Lancet"},{"issue":"1","key":"2021020418562009300_pnaa314-B5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3233\/JAD-189004","article-title":"Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery-20181","volume":"66","author":"Evered","year":"2018","journal-title":"J Alzheimers Dis"},{"issue":"4","key":"2021020418562009300_pnaa314-B6","doi-asserted-by":"crossref","first-page":"e53","DOI":"10.1016\/j.lpm.2018.03.012","article-title":"Postoperative delirium","volume":"47","author":"Rengel","year":"2018","journal-title":"Presse Med"},{"issue":"4","key":"2021020418562009300_pnaa314-B7","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/j.ccc.2008.05.008","article-title":"Delirium in the acute care setting: Characteristics, diagnosis and treatment","volume":"24","author":"Maldonado","year":"2008","journal-title":"Crit Care Clin"},{"key":"2021020418562009300_pnaa314-B8","volume-title":"Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research","year":"2011"},{"issue":"12","key":"2021020418562009300_pnaa314-B9","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1016\/j.pain.2013.06.012","article-title":"The impact of pain upon cognition: What have rodent studies told us?","volume":"154","author":"Low","year":"2013","journal-title":"Pain"},{"issue":"2","key":"2021020418562009300_pnaa314-B10","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1097\/SPC.0000000000000054","article-title":"Cognition and pain","volume":"8","author":"Moriarty","year":"2014","journal-title":"Curr Opin Support Palliat Care"},{"issue":"10","key":"2021020418562009300_pnaa314-B11","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1016\/j.jagp.2013.01.069","article-title":"Does preoperative risk for delirium moderate the effects of postoperative pain and opiate use on postoperative delirium?","volume":"21","author":"Leung","year":"2013","journal-title":"Am J Geriatr Psychiatry"},{"issue":"4","key":"2021020418562009300_pnaa314-B12","first-page":"1267","article-title":"Postoperative delirium: The importance of pain and pain management","volume":"102","author":"Vaurio","year":"2006","journal-title":"AnesthAnalg"},{"issue":"6","key":"2021020418562009300_pnaa314-B13","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/S2215-0366(14)00006-6","article-title":"Effect of preoperative pain and depressive symptoms on the development of postoperative delirium","volume":"1","author":"Kosar","year":"2014","journal-title":"Lancet Psychiatry"},{"issue":"6","key":"2021020418562009300_pnaa314-B14","doi-asserted-by":"crossref","first-page":"474","DOI":"10.7326\/0003-4819-119-6-199309150-00005","article-title":"A predictive model for delirium in hospitalized elderly medical patients based on admission characteristics","volume":"119","author":"Inouye","year":"1993","journal-title":"Ann Intern Med"},{"key":"2021020418562009300_pnaa314-B15","first-page":"Cd011145.pub2","volume-title":"Cochrane Database Syst Rev","author":"Creavin","year":"2016"},{"key":"2021020418562009300_pnaa314-B16","first-page":"1346","article-title":"Evaluation of the postoperative cognitive dysfunction in elderly patients with general anesthesia","volume":"21","author":"Chi","year":"2017","journal-title":"Eur Rev Med Pharmacol Sci"},{"issue":"4","key":"2021020418562009300_pnaa314-B17","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1111\/j.1532-5415.2005.53221.x","article-title":"The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment","volume":"53","author":"Nasreddine","year":"2005","journal-title":"J Am Geriatr Soc"},{"issue":"8","key":"2021020418562009300_pnaa314-B18","doi-asserted-by":"crossref","first-page":"1923","DOI":"10.1016\/j.avsg.2014.07.004","article-title":"C-reactive protein predicts postoperative delirium following vascular surgery","volume":"28","author":"Pol","year":"2014","journal-title":"Ann Vasc Surg"},{"issue":"8","key":"2021020418562009300_pnaa314-B19","doi-asserted-by":"crossref","first-page":"e109","DOI":"10.1111\/jgs.14913","article-title":"High C-reactive protein predicts delirium incidence, duration, and feature severity after major noncardiac surgery","volume":"65","author":"Vasunilashorn","year":"2017","journal-title":"J Am Geriatr Soc"},{"issue":"3","key":"2021020418562009300_pnaa314-B20","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1016\/j.jvs.2017.03.439","article-title":"Risk factors for postoperative delirium in patients undergoing vascular surgery","volume":"66","author":"Galyfos","year":"2017","journal-title":"J Vasc Surg"},{"issue":"11","key":"2021020418562009300_pnaa314-B21","doi-asserted-by":"crossref","first-page":"e149","DOI":"10.1111\/jgs.14428","article-title":"A simple tool to predict development of delirium after elective surgery","volume":"64","author":"Dworkin","year":"2016","journal-title":"J Am Geriatr Soc"},{"issue":"3","key":"2021020418562009300_pnaa314-B22","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.bpa.2012.07.003","article-title":"Epidemiology and risk factors for delirium across hospital settings","volume":"26","author":"Vasilevskis","year":"2012","journal-title":"Best Pract Res Clin Anaesthesiol"},{"issue":"02","key":"2021020418562009300_pnaa314-B23","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1017\/S104161020600425X","article-title":"The incidence of delirium associated with orthopedic surgery: A meta-analytic review","volume":"19","author":"Bruce","year":"2007","journal-title":"Int Psychogeriatr"},{"issue":"11","key":"2021020418562009300_pnaa314-B24","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1515\/hsz-2015-0149","article-title":"C-reactive protein and inflammation: Conformational changes affect function","volume":"396","author":"Wu","year":"2015","journal-title":"Biol Chem"},{"issue":"12","key":"2021020418562009300_pnaa314-B25","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1172\/JCI200318921","article-title":"C-reactive protein: A critical update","volume":"111","author":"Pepys","year":"2003","journal-title":"J Clin Invest"},{"issue":"4","key":"2021020418562009300_pnaa314-B26","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1159\/000078350","article-title":"Different C-reactive protein kinetics in post-operative hip-fractured geriatric patients with and without complications","volume":"50","author":"Beloosesky","year":"2004","journal-title":"Gerontology"},{"issue":"4","key":"2021020418562009300_pnaa314-B27","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1053\/j.jvca.2010.01.003","article-title":"Modifiable and nonmodifiable risk factors for postoperative delirium after cardiac surgery with cardiopulmonary bypass","volume":"24","author":"Burkhart","year":"2010","journal-title":"J Cardiothorac Vasc Anesth"},{"issue":"1","key":"2021020418562009300_pnaa314-B28","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.jcrc.2013.09.002","article-title":"Prediction of delirium in critically ill patients with elevated C-reactive protein","volume":"29","author":"Zhang","year":"2014","journal-title":"J Crit Care"},{"key":"2021020418562009300_pnaa314-B29","first-page":"376","author":"\u00c7inar","year":"2014"},{"issue":"2","key":"2021020418562009300_pnaa314-B30","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/j.genhosppsych.2013.10.010","article-title":"Delirium in patients admitted to a cardiac intensive care unit with cardiac emergencies in a developing country: Incidence, prevalence, risk factor and outcome","volume":"36","author":"Lahariya","year":"2014","journal-title":"Gen Hosp Psychiatry"},{"issue":"7","key":"2021020418562009300_pnaa314-B31","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1177\/2048872617695235","article-title":"Long-term prognostic value of delirium in elderly patients with acute cardiac diseases admitted to two cardiac intensive care units: A prospective study (DELIRIUM CORDIS)","volume":"7","author":"Falsini","year":"2018","journal-title":"Eur Heart J Acute Cardiovasc Care"},{"issue":"4","key":"2021020418562009300_pnaa314-B32","first-page":"214","article-title":"Delirium in the elderly","volume":"60","author":"Alakkassery","year":"2012","journal-title":"Lebanese Med J"},{"issue":"4","key":"2021020418562009300_pnaa314-B33","first-page":"271","article-title":"Optimizing delirium prediction model in the management of hospitalized elderly patients","volume":"44","author":"Harimurti","year":"2012","journal-title":"Acta Med Indones"},{"issue":"3","key":"2021020418562009300_pnaa314-B34","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1093\/bja\/aeu458","article-title":"Impact of intraoperative hypotension and blood pressure fluctuations on early postoperative delirium after non-cardiac surgery","volume":"115","author":"Hirsch","year":"2015","journal-title":"Br J Anaesth"},{"issue":"3","key":"2021020418562009300_pnaa314-B35","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.jpsychores.2008.05.019","article-title":"Unravelling the pathophysiology of delirium: A focus on the role of aberrant stress responses","volume":"65","author":"Maclullich","year":"2008","journal-title":"J Psychosom Res"}],"container-title":["Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/painmedicine\/article-pdf\/22\/1\/15\/36196105\/pnaa314.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/painmedicine\/article-pdf\/22\/1\/15\/36196105\/pnaa314.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T12:45:40Z","timestamp":1612788340000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/painmedicine\/article\/22\/1\/15\/5920816"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,11]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,10,11]]},"published-print":{"date-parts":[[2021,2,4]]}},"URL":"https:\/\/doi.org\/10.1093\/pm\/pnaa314","relation":{},"ISSN":["1526-2375","1526-4637"],"issn-type":[{"value":"1526-2375","type":"print"},{"value":"1526-4637","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,1,1]]},"published":{"date-parts":[[2020,10,11]]}}}