Correlation analysis between serum plasminogen activator inhibitor-1 and apolipoprotein A1 levels and postoperative delirium and postoperative cognitive dysfunction in elderly patients undergoing hip or knee arthroplasty
Objective To analyze the correlation analysis between serum plasminogen activator inhibitor-1(PAI-1)and apolipoprotein A1(ApoA1)levels and postoperative delirium(POD)and postoperative cognitive dysfunction(POCD)in elderly patients undergoing hip or knee arthroplasty.Method A total of 122 elderly patients undergoing hip or knee arthroplasty admitted to the Shijiazhuang Third Hospital from March 2021 to March 2023 were selected as the study subjects.According to whether POD occurred,the study subjects were divided into POD group(20 cases with POD)and non-POD group(102 cases without POD).According to whether POCD occurred,the subjects were divided into PCOD group(30 cases with POCD)and non-POCD group(92 cases without POCD).The clinical features between non-POD group and POD group,non-POCD group and POCD group were compared and analyzed.Multivariate logistic regression method was used to analyze the influencing factors of POD and POCD in elderly patients.Result The intraoperative blood loss in POD group was higher than that in non-POD group,and PAI-1 and ApoA1 were lower than those in non-POD group,with statistical significance(P＜0.05).The proportion of high school education or below in POCD group was higher than that in non-POCD group,PAI-1 and ApoA1 were lower than those in non-POCD group,with statistical significance(P＜0.05).Multivariate logistic regression analysis showed that intraoperative blood loss was an independent risk factor for POD in elderly patients(P＜0.05),and PAI-1 and ApoA1 were independent protective factors for POD in elderly patients(P＜0.05).High school education or below was an independent risk factor for POCD in elderly patients(P＜0.05),and PAI-1 and ApoA1 were independent protective factors for POCD in elderly patients(P＜0.05).Conclusion PAI-1 and ApoA1 levels were independent protective factors for POD and POCD in elderly patients undergoing hip or knee arthroplasty.
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