{
  "abstract": "BackgroundPostoperative delirium (POD) is common in elderly patients and is linked to poor recovery and greater mortality. Inflammation has been implicated in its pathophysiology and recent meta-analysis suggests steroids may have utility in preventing POD. This study aimed to evaluate whether C-reactive protein (CRP) predicts severity (or incidence) of POD. Our secondary outcome analysed whether anti-emetic doses of dexamethasone meaningfully altered inflammatory responses in this age group.\n\nMethodsPatients (n=122) [≥]60 years of age undergoing major surgery were recruited to a prospective cohort study in which CRP was measured preoperatively and on postoperative day 1. Delirium was assessed using the 3-minute diagnostic Confusion Assessment Method (3D-CAM) twice daily on days 1-3. CRP was analysed against the outcomes of incidence (positive overall 3D-CAM) and peak severity (maximum 3D-CAM score) of POD.\n\nResultsPOD occurred in 20/122 (16.4%); mean peak severity 2.1 (SD 2.1). Postoperative CRP was associated with the primary outcome, POD severity (predicted probability 94.7%) as well as incidence (predicted probability 99.9%). Dexamethasone reduced CRP by 41% (95% CrI 8-62%, predicted probability 99.1%).\n\nConclusionRoutine postoperative CRP was independently associated with POD incidence and severity. Dexamethasone, at anti-emetic doses, was associated with a substantial reduction in CRP levels, supporting trials focussed on modulating inflammation to prevent delirium.",
  "abstract_shown": true,
  "affiliations": [
    "Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "F. Schnitzler"
    },
    {
      "name": "K. Kramer"
    },
    {
      "name": "S. Curtis"
    },
    {
      "name": "B. Anderson"
    },
    {
      "name": "K. Matsis"
    },
    {
      "name": "A. Lawrence"
    },
    {
      "name": "G. Wong"
    },
    {
      "name": "B. Moran"
    },
    {
      "name": "N. Pillinger"
    },
    {
      "name": "R. Sanders"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5a36ce47305mq.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.10.22.26366074",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.10.22.26366074v1.full",
  "id": "5a36ce47305mq",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.10.22.26366074v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "anesthesia"
    ],
    [
      "openalex",
      "2706|Intensive Care Unit Cognitive Disorders"
    ]
  ],
  "openalex": "W7223298811",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.10.22.26366074v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-22",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/5a36ce47305mq.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:34Z",
      "native_id": "10.64898/2026.10.22.26366074",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.10.22.26366074v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:anesthesia",
      "subfield": "surgery"
    }
  ],
  "title": "The association of C-Reactive Protein with Delirium Severity: An analysis of a prospective cohort study",
  "title_text": "The association of C-Reactive Protein with Delirium Severity: An analysis of a prospective cohort study",
  "type": "preprint",
  "updated_at": "2026-10-30T12:21:34Z",
  "url": "https://research.draconitic.com/paper/5a36ce47305mq",
  "venue": "medRxiv",
  "versions": []
}