{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:17:51Z","timestamp":1785773871481,"version":"3.56.0"},"reference-count":54,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"unspecified","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,8,26]]},"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To assess the correlation between complete blood count (CBC)-derived inflammatory markers and sepsis-associated delirium (SAD) risk in older intensive care unit (ICU) patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Retrospective cohort study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>ICUs at Beth Israel Deaconess Medical Center (2008\u20132019), using the Medical Information Mart for Intensive Care IV V.3.0 database.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>3412 critically ill patients aged \u226565 years with sepsis. Exclusion: repeated ICU admission, death\/discharge within 24 hours, missing delirium assessment or pre-sepsis delirium from non-septic aetiologies. SAD was diagnosed by Confusion Assessment Method for the ICU.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Primary outcome measure<\/jats:title>\n                  <jats:p>Incidence of sepsis-associated delirium.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 3412 older sepsis patients, 2092 (61.3%) developed SAD. Significant differences in platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index, systemic inflammation response index, pan-immune-inflammation value and neutrophil-monocyte-to-lymphocyte ratio were observed between SAD and non-SAD groups (all p&lt;0.001). After multivariable adjustment, elevated levels of these markers were associated with increased SAD risk, with MLR showing the strongest association (Q4 vs Q1 adjusted OR=2.66, 95%\u2009CI 2.14 to 3.30). Restricted cubic spline analysis revealed non-linear associations between inflammatory marker levels and SAD risk (p for non-linear &lt;0.001). The results of most subgroup analyses were consistent, indicating that the association between inflammatory markers and SAD had high stability (p for interaction &gt;0.05). Receiver operating characteristic and random forest analyses demonstrated predictive utility; incorporating markers into a baseline model significantly improved discrimination, with MLR providing the largest gain (area under the curve (AUC)=0.716 vs 0.703; \u0394AUC=0.013, DeLong test, p&lt;0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>CBC-derived inflammatory markers, particularly MLR, are associated with increased SAD risk in older adults and enhance the performance of a clinical prediction model in this population. Further research is needed to better understand the pathophysiological mechanisms underlying these associations.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-101960","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T08:06:05Z","timestamp":1759305965000},"page":"e101960","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Correlation between complete blood count-derived inflammatory markers and sepsis-associated delirium in older patients: a retrospective analysis of the MIMIC-IV database"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3052-8709","authenticated-orcid":false,"given":"Lu","family":"Wang","sequence":"first","affiliation":[{"name":"Departments of Critical Care Medicine, Harbin Medical University Cancer Hospital, Harbin, 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