{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:39:26Z","timestamp":1789000766136,"version":"build-2803163510"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T00:00:00Z","timestamp":1713484800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Postoperative delirium (POD) remains one of the most prevalent neuropsychiatric complications after deep brain stimulation (DBS) surgery. The fibrinogen-to-albumin ratio (FAR) has been shown to significantly correlate with the prognosis of many diseases related to inflammation. However, the association between FAR and POD remains unclear. We aimed to explore the association between POD and FAR in patients with Parkinson\u2019s disease (PD) undergoing DBS surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with PD who underwent DBS surgery in our hospital were included in this retrospective study. FAR was calculated from the blood sample collected on admission. The association between baseline FAR and delirium after surgery was assessed by binary logistic regression analysis, interaction analysis, and stratified analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 226 patients, 37 (16.4%) suffered from delirium after surgery. The average age of the participants was 63.3\u2009\u00b1\u20097.2\u2009years, and 51.3% were male patients. Multivariate logistic regression analysis indicated that patients in the highest FAR tertile had a higher risk of POD compared with patients in the lowest FAR tertile (OR\u2009=\u20093.93, 95% CI: 1.24\u2009~\u200912.67). Subgroup analysis demonstrated that FAR and the preoperative Mini-Mental State Examination score (<jats:italic>p<\/jats:italic>\u2009=\u20090.013) had an association with delirium after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our data suggest that a higher preoperative FAR was significantly associated with delirium after DBS surgery. FAR on admission is a useful candidate biomarker to identify patients with PD who are at a high risk of delirium following DBS surgery.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2024.1381967","type":"journal-article","created":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T05:08:30Z","timestamp":1713503310000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["The association between the fibrinogen-to-albumin ratio and delirium after deep brain stimulation surgery in Parkinson\u2019s disease"],"prefix":"10.3389","volume":"11","author":[{"given":"Wenbin","family":"Lu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengwei","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinning","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiali","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiya","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,4,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"101554","DOI":"10.1016\/j.arr.2021.101554","article-title":"Roles of clock genes in the pathogenesis of Parkinson's disease","volume":"74","author":"Shkodina","year":"2022","journal-title":"Ageing Res Rev"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1004","DOI":"10.3390\/cells12071004","article-title":"Effect of the metabotropic glutamate receptor type 5 negative allosteric modulator dipraglurant on motor and non-motor symptoms of Parkinson's disease","volume":"12","author":"Epping-Jordan","year":"2023","journal-title":"Cells"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1001\/jama.2019.22360","article-title":"Diagnosis and treatment of Parkinson disease: a review","volume":"323","author":"Armstrong","year":"2020","journal-title":"JAMA"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"699","DOI":"10.3233\/JPD-212883","article-title":"Personality related to quality-of-life improvement after deep brain stimulation in Parkinson's disease (PSYCHO-STIM II)","volume":"12","author":"Boussac","year":"2022","journal-title":"J Parkinsons Dis"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"25","DOI":"10.3390\/brainsci13010025","article-title":"Risk factors for delirium after deep brain stimulation surgery under Total intravenous anesthesia in Parkinson's disease patients","volume":"13","author":"Lu","year":"2022","journal-title":"Brain Sci"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"e127","DOI":"10.1016\/j.wneu.2020.03.160","article-title":"Nomogram model for predicting risk of postoperative delirium after deep brain stimulation surgery in patients older than 50 years with Parkinson disease","volume":"139","author":"Zhan","year":"2020","journal-title":"World Neurosurg"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"111030","DOI":"10.1016\/j.jclinane.2022.111030","article-title":"Postoperative delirium: an independent risk factor for poorer quality of life with long-term cognitive and functional decline after cardiac surgery","volume":"85","author":"de la Varga-Mart\u00ednez","year":"2023","journal-title":"J Clin Anesth"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1097\/EJA.0000000000001811","article-title":"Developing and validating a machine learning ensemble model to predict postoperative delirium in a cohort of high-risk surgical patients: a secondary cohort analysis","volume":"40","author":"PCS","year":"2023","journal-title":"Eur J Anaesthesiol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1097\/ANA.0000000000000861","article-title":"Current recommendations for perioperative brain health: a scoping review","volume":"35","author":"Wooding","year":"2023","journal-title":"J Neurosurg Anesthesiol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1016\/j.bja.2022.01.005","article-title":"Postoperative delirium and changes in the blood-brain barrier, neuroinflammation, and cerebrospinal fluid lactate: a prospective cohort study","volume":"129","author":"Taylor","year":"2022","journal-title":"Br J Anaesth"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1016\/j.nut.2019.06.006","article-title":"Association between preoperative nutritional status and postoperative delirium in individuals with coronary artery bypass graft surgery: A prospective cohort study","volume":"66","author":"Velayati","year":"2019","journal-title":"Nutrition"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1186\/s12957-022-02793-x","article-title":"Risk factors and a nomogram model for postoperative delirium in elderly gastric cancer patients after laparoscopic gastrectomy","volume":"20","author":"Chen","year":"2022","journal-title":"World J Surg Oncol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e2390","DOI":"10.1002\/rmv.2390","article-title":"Prognostic value of novel serum biomarkers, including C-reactive protein to albumin ratio and fibrinogen to albumin ratio, in COVID-19 disease: a meta-analysis","volume":"32","author":"Rathore","year":"2022","journal-title":"Rev Med Virol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"985377","DOI":"10.3389\/fonc.2022.985377","article-title":"The prognostic value of fibrinogen to albumin ratio in malignant tumor patients: a meta-analysis","volume":"12","author":"Li","year":"2022","journal-title":"Front Oncol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1213\/ANE.0000000000005948","article-title":"Association between preoperative fibrinogen-to-albumin ratio and all-cause mortality after off-pump coronary artery bypass grafting: a retrospective observational study","volume":"134","author":"Park","year":"2022","journal-title":"Anesth Analg"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1002\/clc.23981","article-title":"Fibrinogen-albumin ratio predicting major adverse cardiovascular outcomes post-percutaneous coronary intervention: a systematic review and exploratory meta-analysis","volume":"46","author":"Desai","year":"2023","journal-title":"Clin Cardiol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"7063","DOI":"10.1245\/s10434-021-10027-9","article-title":"Fibrinogen-albumin ratio as a new promising preoperative biochemical marker for predicting oncological outcomes in gastric Cancer: a multi-institutional study","volume":"28","author":"Lin","year":"2021","journal-title":"Ann Surg Oncol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1025","DOI":"10.7150\/jca.16491","article-title":"A novel blood tool of cancer prognosis in esophageal squamous cell carcinoma: the fibrinogen\/albumin ratio","volume":"8","author":"Tan","year":"2017","journal-title":"J Cancer"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1186\/s12877-023-04629-z","article-title":"Preoperative prognostic nutritional index value as a predictive factor for postoperative delirium in older adult patients with hip fractures: a secondary analysis","volume":"24","author":"Mi","year":"2024","journal-title":"BMC Geriatr"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"67","DOI":"10.3389\/fnagi.2020.00067","article-title":"Exosome \u03b1-Synuclein release in plasma may be associated with postoperative delirium in hip fracture patients","volume":"12","author":"Yuan","year":"2020","journal-title":"Front Aging Neurosci"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1645","DOI":"10.3390\/brainsci12121645","article-title":"Optimal contact position of subthalamic nucleus deep brain stimulation for reducing restless legs syndrome in Parkinson's disease patients: one-year follow-up with 33 patients","volume":"12","author":"Lei","year":"2022","journal-title":"Brain Sci"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1186\/s12933-022-01662-x","article-title":"The association between fibrinogen-to-albumin ratio (FAR) and adverse prognosis in patients with acute decompensated heart failure at different glucose metabolic states","volume":"21","author":"Huang","year":"2022","journal-title":"Cardiovasc Diabetol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1111\/cns.13991","article-title":"Comparison of logistic regression and machine learning methods for predicting postoperative delirium in elderly patients: a retrospective study","volume":"29","author":"Song","year":"2023","journal-title":"CNS Neurosci Ther"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"110957","DOI":"10.1016\/j.jclinane.2022.110957","article-title":"Association between post-operative delirium and use of volatile anesthetics in the elderly: a real-world big data approach","volume":"83","author":"Saller","year":"2022","journal-title":"J Clin Anesth"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"106854","DOI":"10.1016\/j.ijsu.2022.106854","article-title":"The impact of regional versus general anesthesia on postoperative neurocognitive outcomes in elderly patients undergoing hip fracture surgery: a systematic review and meta-analysis","volume":"105","author":"Bhushan","year":"2022","journal-title":"Int J Surg"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"24 (4)","DOI":"10.3390\/ijms24043278","article-title":"Hot spots for the use of intranasal insulin: cerebral ischemia, brain injury, diabetes mellitus Endocrine Disorders and Postoperative Delirium","volume":"24","author":"Shpakov","year":"2023","journal-title":"Int J Mol Sci"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1186\/s12877-022-03367-y","article-title":"Higher serum PGE2 is a predicative biomarker for postoperative delirium following elective orthopedic surgery in elderly patients","volume":"22","author":"Mao","year":"2022","journal-title":"BMC Geriatr"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2022\/9755129","article-title":"Association between baseline cognitive score and postoperative delirium in Parkinson's disease patients following deep brain stimulation surgery","volume":"2022","author":"Zhou","year":"2022","journal-title":"Parkinsons Dis"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1016\/j.anl.2023.01.005","article-title":"Postoperative serum interleukin-6 level as a risk factor for development of hyperactive delirium with agitation after head and neck surgery with free tissue transfer reconstruction","volume":"50","author":"Imai","year":"2023","journal-title":"Auris Nasus Larynx"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"950188","DOI":"10.3389\/fnagi.2022.950188","article-title":"Early alteration of peripheral blood lymphocyte subsets as a risk factor for delirium in critically ill patients after cardiac surgery: a prospective observational study","volume":"14","author":"Li","year":"2022","journal-title":"Front Aging Neurosci"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"105482","DOI":"10.1016\/j.nbd.2021.105482","article-title":"Parkinson's disease risk genes act in glia to control neuronal \u03b1-synuclein toxicity","volume":"159","author":"Olsen","year":"2021","journal-title":"Neurobiol Dis"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1007\/s00115-020-00876-2","article-title":"Delirium in idiopathic Parkinson's disease","volume":"91","author":"Franke","year":"2020","journal-title":"Nervenarzt"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1016\/j.bja.2021.04.033","article-title":"Preoperative inflammatory mediators and postoperative delirium: systematic review and meta-analysis","volume":"127","author":"Noah","year":"2021","journal-title":"Br J Anaesth"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"2590","DOI":"10.18632\/aging.203955","article-title":"The TLR4\/NF-\u03baB\/MAGI-2 signaling pathway mediates postoperative delirium","volume":"14","author":"Zhang","year":"2022","journal-title":"Aging"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"646265","DOI":"10.3389\/fphar.2021.646265","article-title":"Dexmedetomidine mitigated NLRP3-mediated Neuroinflammation via the ubiquitin-autophagy pathway to improve perioperative neurocognitive disorder in mice","volume":"12","author":"Zhang","year":"2021","journal-title":"Front Pharmacol"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"110408","DOI":"10.1016\/j.jclinane.2021.110408","article-title":"Development and validation of a risk score for predicting postoperative delirium after major abdominal surgery by incorporating preoperative risk factors and surgical Apgar score","volume":"75","author":"Li","year":"2021","journal-title":"J Clin Anesth"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1177\/0003319718822244","article-title":"Blood viscosity should not be overlooked when evaluating the fibrinogen to albumin ratio","volume":"70","author":"Ozcan Cetin","year":"2019","journal-title":"Angiology"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"3090","DOI":"10.1111\/jth.15545","article-title":"Oxidative stress mediated platelet activation in patients with congenital analbuminemia: effect of albumin infusion","volume":"19","author":"Baratta","year":"2021","journal-title":"J Thromb Haemost"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"732","DOI":"10.1007\/s12603-022-1821-9","article-title":"Postoperative pneumonia and aspiration pneumonia following elderly hip fractures","volume":"26","author":"Ahn","year":"2022","journal-title":"J Nutr Health Aging"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"1294","DOI":"10.1080\/07853890.2023.2192047","article-title":"Research progress and value of albumin-related inflammatory markers in the prognosis of non-small cell lung cancer: a review of clinical evidence","volume":"55","author":"Zhang","year":"2023","journal-title":"Ann Med"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1099","DOI":"10.1016\/j.neuron.2019.01.014","article-title":"Fibrinogen induces microglia-mediated spine elimination and cognitive impairment in an Alzheimer's disease model","volume":"101","author":"Merlini","year":"2019","journal-title":"Neuron"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"5632","DOI":"10.3390\/cancers14225632","article-title":"Neutrophil-lymphocyte ratio, and carbohydrate antigen 125 for predicting endometrial Cancer prognosis","volume":"14","author":"Li","year":"2022","journal-title":"Cancers"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"114600","DOI":"10.1016\/j.ecoenv.2023.114600","article-title":"Fibrinogen on extracellular vesicles derived from polyhexamethylene guanidine phosphate-exposed mice induces inflammatory effects via integrin \u03b2","volume":"252","author":"Kim","year":"2023","journal-title":"Ecotoxicol Environ Saf"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"1083752","DOI":"10.3389\/fneur.2023.1083752","article-title":"Fibrinogen-to-albumin ratio percentage: an independent predictor of disease severity and prognosis in anti-N-methyl-D-aspartate receptor encephalitis","volume":"14","author":"du","year":"2023","journal-title":"Front Neurol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1381967\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T05:08:34Z","timestamp":1713503314000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1381967\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,19]]},"references-count":44,"alternative-id":["10.3389\/fmed.2024.1381967"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2024.1381967","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,19]]},"article-number":"1381967"}}