Objective To investigate the predictive value of preoperative levels of serum brain⁃derived neurotrophic factor (BDNF), lipoprotein⁃associated phospholipase A2 (Lp⁃PLA2), and superoxide dismutase (SOD) on the occurrence of postoperative delirium in elderly patients with total hip replacement. Methods A total of 164 elderly patients undergoing total hip replacement via general anesthesia were selected as the research subjects, and they were assigned to postoperative delirium group or non⁃postoperative delirium group according to the occurrence of delirium within 1 week after operation. The general data, operation⁃related data, and preoperative hemoglobin, and serum BDNF, Lp⁃PLA2, SOD, albumin levels were compared between patients of the two groups. The multivariate Logistic regression model was used to analyze the influencing factors for elderly patients suffering from delirium after total hip replacement. The receiver operating characteristic (ROC) curve was drawn to analyze the value of preoperative serum BDNF, Lp⁃PLA2, and SOD levels for predicting elderly patients suffering from delirium after total hip replacement. Results A total of 27 patients suffered from delirium after operation, with the incidence rate of 16.5%. Compared with the non⁃postoperative delirium group, patients of the postoperative delirium group were older, and obtained longer operation duration and recovery time, a higher American Society of Anesthesiologists (ASA) classification, and lower levels of preoperative serum BDNF, SOD, and albumin, whereas a higher level of preoperative serum Lp⁃PLA2 (P<0.05). The results of multivariate Logistic regression analysis revealed that advanced age, ASA classification in Ⅲ, recovery time≥60 minutes, and elevated preoperative serum Lp⁃PLA2 level were the independent risk factors for elderly patients suffering from delirium after total hip replacement, and elevations of serum BDNF and SOD levels were the independent protective factors (P<0.05). The results of ROC curve analysis indicated that areas under the curve of preoperative serum BDNF, Lp⁃PLA2, and SOD levels for predicting elderly patients suffering from delirium after operation were 0.762, 0.766, and 0.883, respectively, and area under the curve predicted by the combination of the three indices was 0.932. Conclusion Preoperative serum BDNF, Lp⁃PLA2, and SOD levels are the independent influencing factors for elderly patients suffering from delirium after total hip replacement, the three exert predictive efficiency on the occurrence of delirium after operation to a certain extent, and the combination of the three exerts a superior predictive effect.

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