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系统免疫炎症指数(SII)和全身炎症反应指数(SIRI)可预测行非体外循环冠状动脉旁路移植术(OPCABG)合并脑梗死患者术后谵妄。

Systemic immune inflammatory index (SII) and systemic inflammatory response index (SIRI) as predictors of postoperative delirium in patients undergoing off-pump coronary artery bypass grafting (OPCABG) with cerebral infarction.

机构信息

Department of Anesthesiology, Tianjin Chest Hospital, Tianjin, 300222, China.

Tianjin Institute of Cardiovascular Disease, Tianjin, China.

出版信息

BMC Surg. 2024 Oct 28;24(1):338. doi: 10.1186/s12893-024-02598-7.

DOI:10.1186/s12893-024-02598-7
PMID:39468504
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11520795/
Abstract

OBJECTIVE

Postoperative delirium (POD) is a common complication following off-pump coronary artery bypass grafting (OPCABG) and is associated with significant morbidity. This study aims to evaluate the correlation of systemic immune inflammatory index (SII) and systemic inflammatory response index (SIRI) with postoperative delirium (POD) in patients with cerebral infarction undergoing OPCABG.

METHODS

The perioperative cohort study included 321 patients who underwent OPCABG. Patients were divided into two groups based on the occurrence of POD: the delirium group (n = 113) and the non-delirium group (n = 208). Baseline characteristics, including gender, left ventricular ejection fraction (LVEF), surgery duration, hypertension, age, and smoking history were analyzed. SII and SIRI values were calculated preoperatively, and their association with POD was assessed using univariate and multivariate logistic regression analyses. Receiver operating characteristic (ROC) curves were used to evaluate the predictive accuracy of SII and SIRI.

RESULTS

Statistical differences between SII and SIRI in the two groups (P < 0.05) were observed. Multivariate analysis confirmed that SII and SIRI, age and preoperative smoking history were predictors of POD. ROC curve analysis demonstrated that SII and SIRI had considerable predictive power, with AUC values of 0.73 (0.67-0.79) for SII and 0.75 (0.69-0.81) for SIRI.

CONCLUSION

SII and SIRI were found to be associated with an increased risk of POD in patients undergoing OPCABG, but further research is needed to confirm these findings and determine their independence as risk factors.

摘要

目的

术后谵妄(POD)是体外循环冠状动脉旁路移植术(OPCABG)后的常见并发症,与显著的发病率相关。本研究旨在评估系统性免疫炎症指数(SII)和系统性炎症反应指数(SIRI)与脑梗死患者接受 OPCABG 术后谵妄(POD)的相关性。

方法

这是一项围手术期的队列研究,共纳入 321 例接受 OPCABG 的患者。根据是否发生 POD,患者分为谵妄组(n=113)和非谵妄组(n=208)。分析了基线特征,包括性别、左心室射血分数(LVEF)、手术时间、高血压、年龄和吸烟史。术前计算 SII 和 SIRI 值,并使用单因素和多因素逻辑回归分析评估它们与 POD 的相关性。使用受试者工作特征(ROC)曲线评估 SII 和 SIRI 的预测准确性。

结果

两组间 SII 和 SIRI 存在统计学差异(P<0.05)。多因素分析证实 SII 和 SIRI、年龄和术前吸烟史是 POD 的预测因素。ROC 曲线分析表明 SII 和 SIRI 具有相当的预测能力,SII 的 AUC 值为 0.73(0.67-0.79),SIRI 的 AUC 值为 0.75(0.69-0.81)。

结论

SII 和 SIRI 与 OPCABG 患者 POD 的风险增加相关,但需要进一步研究来证实这些发现,并确定它们作为风险因素的独立性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86e8/11520795/c12b3b1e1387/12893_2024_2598_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86e8/11520795/3ed10d30bb76/12893_2024_2598_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86e8/11520795/d2f56370f611/12893_2024_2598_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86e8/11520795/c12b3b1e1387/12893_2024_2598_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86e8/11520795/3ed10d30bb76/12893_2024_2598_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86e8/11520795/d2f56370f611/12893_2024_2598_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86e8/11520795/c12b3b1e1387/12893_2024_2598_Fig3_HTML.jpg

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