Luo Ning, Gao Xiaowei, Ye Chunyan, Wang Lu, Tang Lu, Xie Yongqiu, Wang E
Department of Anesthesiology, Xiangya Hospital Central South University, Changsha, 410008, China.
National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Xiangya Road #87, Changsha, Hunan, 410008, China.
Perioper Med (Lond). 2024 Jul 16;13(1):75. doi: 10.1186/s13741-024-00432-5.
Delayed neurocognitive recovery (DNR) is a common complication in patients undergoing laparoscopic surgery, and there are currently no effective therapies. It is vital to provide a reliable basis for clinical prediction. This study tried to analyse the risk factors for DNR in patients undergoing laparoscopic colorectal surgery and to establish a risk prediction model.
A retrospective analysis of the clinical data and DNR status of patients undergoing laparoscopic colorectal surgery at Xiangya Hospital of Central South University from March 2018 to July 2020 was conducted. Logistic regression was performed to analyse the related risk factors for DNR post-operatively, and the predictive model of DNR post-operatively was constructed and validated internally. Patients who underwent laparoscopic colorectal surgery between January and July 2021 were also selected for external validation of the predictive model, to ultimately investigate the risk factors for DNR in patients undergoing laparoscopic colorectal surgery.
The incidence of DNR in patients undergoing laparoscopic colorectal surgery was 15.2% (31/204). The maximum variability of cerebral oxygen, age, education, and pre-existing diabetes was related to the incidence of DNR (p < 0.05). The risk prediction model of DNR after laparoscopic colorectal surgery was established. The internal and external validation showed that the discrimination was good (the AUCs were 0.751 and 0.694, respectively).
The risk prediction model of DNR related to cerebral oxygen saturation monitoring shows good predictive performance and clinical value, providing a basis for postoperative DNR prevention.
延迟神经认知恢复（DNR）是腹腔镜手术患者常见的并发症，目前尚无有效治疗方法。为临床预测提供可靠依据至关重要。本研究试图分析腹腔镜结直肠癌手术患者DNR的危险因素，并建立风险预测模型。
对2018年3月至2020年7月在中南大学湘雅医院接受腹腔镜结直肠癌手术患者的临床资料和DNR状态进行回顾性分析。采用逻辑回归分析术后DNR的相关危险因素，构建并内部验证术后DNR的预测模型。还选取2021年1月至7月接受腹腔镜结直肠癌手术的患者对预测模型进行外部验证，以最终探究腹腔镜结直肠癌手术患者DNR的危险因素。
腹腔镜结直肠癌手术患者DNR发生率为15.2%（31/204）。脑氧最大变异性、年龄、受教育程度和既往糖尿病与DNR发生率相关（p<0.05）。建立了腹腔镜结直肠癌手术后DNR的风险预测模型。内部和外部验证显示区分度良好（AUC分别为0.751和0.694）。
与脑氧饱和度监测相关的DNR风险预测模型具有良好的预测性能和临床价值，为术后DNR预防提供了依据。
