Study on high-risk factors for postoperative delirium in patients after abdominal surgery
Objective To investigate the relationship between perioperative inflammatory cytokine lev-els and the occurrence of postoperative delirium(POD)in patients undergoing abdominal surgery,as well as the high-risk factors for POD,to provide assistance for the prevention of POD.Methods A total of 157 pa-tients who underwent abdominal surgery at Baotou Central Hospital from November 2021 to October 2022 were selected,and 148 patients who met the inclusion/exclusion criteria were screened out.Based on the deliri-um assessment method,combined with the patients'condition and changes in consciousness,they were divided into POD group(43 patients)and non-POD group(105 patients)according to whether they developed POD.General information of the two groups was collected,including age,body mass index,length of hospital stay,etc.Differences in POD occurrence between the two groups were analyzed in combination with perioperative levels of procalcitonin(PCT),C-reactive protein,blood phosphorus,white blood cells,neutrophil percentage,hemoglobin(Hb),and plasma albumin,and risk factors for POD were screened.Results Among the 148 pa-tients,43 developed POD postoperatively,with an incidence rate of 29.05％.Statistically significant differences were observed between the two groups in terms of age,body mass index,hospitalization costs,and PCT,C-re-active protein,plasma albumin,blood phosphorus,neutrophil percentage,and Hb levels(P＜0.05).PCT was identified as a risk factor for POD,while blood phosphorus and Hb were protective factors against POD[odds ratios=1.124,0.001,0.963;95％confidence intervals(95％CI)=1.022-1.238,0.000-0.038,0.933-0.994;P=0.017,＜0.001,0.021].The areas under the curve(AUC)for diagnosing POD using PCT,blood phosphorus,and Hb were 0.904,0.821,and 0.654,respectively,with sensitivities of 0.833,0.857,and 0.907,and specificities of 0.888,0.771,and 0.376,respectively.The cutoff values were 2.95 µg/L,0.88 mmol/L,and 134 g/L,respectively(95％CI=0.840-0.949,0.746-0.881,0.568-0.733;P＜0.001,＜0.001,0.002).The AUC of the logistic stepwise regression model was 0.922,with a sensitivity of 0.829 and a specificity of 0.886(95％CI=0.859-0.963;P＜0.001).Conclusion PCT is a risk factor for POD,while blood phos-phorus and Hb are protective factors.Higher PCT levels and lower blood phosphorus and Hb levels are associ-ated with a greater likelihood of POD.
万方数据
维普
