{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:26:41Z","timestamp":1787066801175,"version":"build-2736575974"},"reference-count":30,"publisher":"SLACK, Inc.","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopedics"],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Postoperative delirium (POD) is frequent after hip fracture surgery, yet objective biomarkers that improve risk stratification beyond age, dementia, and frailty are limited. The serum copper-to-zinc (Cu\/Zn) ratio reflects combined inflammatory and nutritional vulnerability, but its association with POD after hip fracture surgery is uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>We performed a single-center retrospective cohort study of 420 consecutive patients aged \u226565 years undergoing surgery for low-energy hip fracture. The preoperative Cu\/Zn ratio, measured within 48 hours before surgery, was the exposure (prespecified high ratio &gt;2.0). The primary outcome was POD within 7 postoperative days or before discharge. Secondary outcomes were numeric rating scale pain scores, 24-hour morphine-equivalent opioid consumption, and hospital length of stay (LOS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In the matched cohort, POD occurred in 23\/124 (18.5%) patients with low Cu\/Zn ratios and 56\/124 (45.2%) with high ratios (odds ratio [OR], 3.62; 95% confidence interval [CI], 2.04\u20136.42;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). In the full cohort, high Cu\/Zn remained associated with POD after adjustment (adjusted OR, 3.35; 95% CI, 2.00\u20135.59;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). After matching, early postoperative pain and 24-hour opioid consumption were not significantly different, whereas LOS was modestly longer in the high Cu\/Zn group (mean difference = 1.0 day).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>A high preoperative Cu\/Zn ratio (&gt;2.0) was independently associated with increased odds of POD and slightly longer hospital LOS after hip fracture surgery in older adults, with minimal impact on early pain-related outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3928\/01477447-20260604-01","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T14:54:52Z","timestamp":1782399292000},"source":"Crossref","is-referenced-by-count":0,"title":["Preoperative Copper-to-Zinc Ratio and Postoperative Delirium After Hip Fracture Surgery: A Propensity Score-matched Cohort Study"],"prefix":"10.3928","volume":"49","author":[{"given":"Cheol","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine"},{"name":"Institute of Wonk-wang Medical Science"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Jean","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwangjin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jina","family":"Kim","sequence":"additional","affiliation":[{"name":"Wonkwang University School of Medicine, Iksan-si, Jeonbukdo, South Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2308","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2022.1068278"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60688-1"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/gps.70094"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-025-02994-3"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40520-023-02692-5"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11357-011-9252-2"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0891-5849(98)00109-9"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/nu14194107"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10534-022-00414-4"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mad.2015.01.004"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.exger.2025.112963"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-020-00644-1"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12011-021-02765-4"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.3390\/nu12041072"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1080\/00273171.2011.568786"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2022.960364"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04091-1"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000026156"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/ncp.10993"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.6133\/apjcn.202504_34(2).0009"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2301292"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12011-022-03104-x"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00394-016-1281-2"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2025.117428"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(02)00458-X"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0322142"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.14764"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000005841"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40520-021-01961-5"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.829762"}],"container-title":["Orthopedics"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:53:46Z","timestamp":1787064826000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.healio.com\/doi\/10.3928\/01477447-20260604-01"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,1]]},"references-count":30,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,7,1]]}},"alternative-id":["10.3928\/01477447-20260604-01"],"URL":"https:\/\/doi.org\/10.3928\/01477447-20260604-01","relation":{},"ISSN":["0147-7447","1938-2367"],"issn-type":[{"value":"0147-7447","type":"print"},{"value":"1938-2367","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,1]]}}}