{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T01:01:48Z","timestamp":1785805308708,"version":"3.56.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T00:00:00Z","timestamp":1738281600000},"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. Neurol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the association between high-sensitivity C-reactive protein (Hs-CRP) levels and the risk of postoperative delirium (POD) following general anesthesia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective cross-sectional study included 644 patients who underwent general anesthesia. Univariate and multivariate logistic regression analyses were performed to evaluate the relationship between Hs-CRP and POD, with subgroup analyses used to assess stratified associations. Receiver operator characteristic (ROC) curve analysis was employed to assess the predictive efficacy of Hs-CRP for POD. Restricted cubic spline (RCS) analysis was conducted to explore the linear relationship between the log-transformed Hs-CRP (Log<jats:sub>10<\/jats:sub>Hs-CRP) and POD risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The total population consisted of 644 individuals with a mean age of 64.02\u202f\u00b1\u202f13.20\u202fyears, 506 (78.60%) of whom were male, and 114 patients (17.7%) had POD. Compared to the lower Hs-CRP group, patients in the higher Hs-CRP group exhibited higher age, heart rate, white blood cell count, blood urea nitrogen, creatinine, uric acid, fasting glucose, hemoglobin A1c, fibrinogen, D-dimer, and a higher prevalence of CKD, but lower hemoglobin, high-density lipoprotein cholesterol, albumin and estimated glomerular filtration rate. Additionally, the prevalence of POD was higher in the higher Hs-CRP group (24.7% vs. 9.5%, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001). Multivariate logistic regression confirmed that elevated Hs-CRP and its forms (Log<jats:sub>10<\/jats:sub>Hs-CRP, standardized Hs-CRP, and higher Hs-CRP group) consistently increased the risk of POD across all adjusted models (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05). Stratified analyses further highlighted significant associations between Hs-CRP and POD in specific subgroups, notably in patients aged \u226565\u202fyears, female patients, and those with or without hypertension, diabetes, or stroke history, and without chronic kidney disease (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05). ROC curve analysis demonstrated that Hs-CRP had a significant predictive ability for POD in the overall population (AUC\u202f=\u202f0.646), as well as in male (AUC\u202f=\u202f0.644) and female patients (AUC\u202f=\u202f0.654). Additionally, RCS analysis indicated a linear positive association between Log<jats:sub>10<\/jats:sub>Hs-CRP and POD risk (<jats:italic>p<\/jats:italic>\u202f=\u202f0.003, nonlinear <jats:italic>p<\/jats:italic>\u202f=\u202f0.896).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Elevated Hs-CRP levels are significantly associated with an increased risk of POD following general anesthesia.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1516800","type":"journal-article","created":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T14:49:56Z","timestamp":1738334996000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Linear association between high-sensitivity C-reactive protein and postoperative delirium after general anesthesia: a cross-sectional 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