Objective To investigate the predictive value of serum estradiol（E2） combined with sequential organ failure assessment（SOFA） score for concurrent delirium in elderly women with urosepsis.Methods A total of 230 elderly women with urosepsis admitted to the intensive care unit (ICU) of our hospital from January 2019 to August 2021 were selected. According to the presence or absence of delirium, they were divided into delirium group (75 cases) and nondelirium group (155 cases). The general data, SOFA score, acute physiology and chronic health evaluationⅡ（APACHEⅡ）score，and the serum levels of sex hormones，including follicle stimulating hormone（FSH）, luteinizing hormone（LH）,serum E2 were compared between the two groups. Spearson correlation analysis was used to identify the correlation between the serum levels of E2 and SOFA score，APACHEⅡ score. A multivariate logistic regression model analysis was used to investigate the influencing factors of concurrent delirium in elderly women with urosepsis. A receiver operating characteristic（ROC）curve was drawn, and the area under the curve（AUC）was calculated to evaluate the predictive value of each index for concurrent delirium in elderly women with urosepsis.Results The age, proportion of patients with stroke history, proportion of mechanical ventilation, SOFA score, APACHE Ⅱ score, length of ICU stay and 28-day mortality in delirium group were higher than those in non-delirium group, and the differences were statistically significant (all P<0.05). Spearson correlation analysis showed that serum E2 level was significantly positively correlated with SOFA score and APACHE Ⅱscore (r=0.297、0.269，all P<0.001). Multivariate logistic regression analysis showed that mechanical ventilation, SOFA score and elevated serum E2 level were independent risk factors for delirium in elderly women with urosepsis (all P<0.05). ROC curve analysis showed that the AUC of serum E2 and SOFA score alone in predicting delirium in elderly women with urosepsis was 0.795 (95%CI：0.737～0.845) and 0.822 (95%CI：0.766～0.869), respectively. The AUC of the combination of the two could be increased to 0.883 (95%CI：0.834～0.962), and the predictive cut-off values of the two were 34.58 ng/L and 9 points, respectively.Conclusions Elevated serum E2 and SOFA score are independent risk factors for delirium in elderly women with urosepsis. The combined detection of the two indicators can improve the predictive efficiency for delirium in elderly women with urosepsis.
