Background: Delirium is commonly observed among elderly surgical subjects
during the postoperative period, and the incidence of postoperative delirium (POD) in elderly
patients (≥65 years) ranges widely from 10% to 70%. This study aimed at investigating
potential serum predicative factors for POD in elderly patients after open abdominal surgery.
Methods: 140 subjects scheduled to undergo elective gastrointestinal tumor resection via
laparotomy from March, 2013 to May, 2015 were enrolled in this study. Participants enrolled
were evaluated for delirium and delirium severity on preoperative day, postoperative
days 2 and 3. Non-fasting blood samples were collected in the morning on the day before
surgery for the detection of serum cytokines expressions by enzyme-linked immunesorbent
Results: A total of 140 patients were finally enrolled in this study and 36 of them occurred
POD, with a POD incidence of 25.7%. In comparison with non-POD group, the serum levels
of insulin-like growth factor-1 (IGF-1) demonstrated significantly decreased of patients in POD group (P<0.01).
The receiver operating characteristic (ROC) curve analysis revealed that serum IGF-1 levels as potential predicative
factor for POD with the area under the ROC curve (AUC) values of 0. 805, with 95 % confidence interval
(CI) of 0.719-0.891 (P<0.001). Univariate and multivariate logistic regression analysis resulted in serum IGF-1
level as a non-invasive predicative factor for POD (OR=2.52, 95%CI: 1.19-5.43, P=0.019).
Conclusion: Our results showed that serum IGF-1 level was a potential predicative biomarker for POD among
patients undergoing elective gastrointestinal tumor resection via laparotomy.