Zhao Ani, Peng Yanchun, Lin Lingyu, Chen Liangwan, Lin Yanjuan
School of Nursing, Fujian Medical University, Fuzhou, Fujian, People's Republic of China.
Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, 350001, People's Republic of China.
J Inflamm Res. 2024 Dec 27;17:11729-11739. doi: 10.2147/JIR.S499836. eCollection 2024.
Postoperative cognitive dysfunction (POCD) is associated with adverse outcomes of cardiac surgery. This study investigated the potential of pre-operative hypersensitive C-reactive protein (Hs-CRP) as a prognostic indicator of POCD in valvular disease (VHD).
This study retrospectively analyzed 372 VHD patients admitted to the Department of Cardiac Surgery, Fujian Medical University Union Hospital from January 2024 to July 2024. POCD was evaluated by neuropsychological examination before and one month after surgery. Demographics, disease history, blood biochemical parameters, and perioperative data were collected. Patients were divided into a POCD group (N = 103) and a non-POCD group (N = 269) according to the occurrence of POCD. A logistic regression model was used to analyze the relationship between Hs-CPR and POCD in VHD patients.
The 1-month incidence of POCD in VHD patients was 27.6%. There was statistical significance in age and years of education between the two groups ( = 0.047, = 0.001). The red blood cell count in the POCD group was lower than that in the non-POCD group ( = 0.025), and the Hs-CRP and mechanical ventilation duration in the POCD group was higher than that in the non-POCD group, with statistical significance ( < 0.001). No significant differences were observed in the results of demographic characteristics and other laboratory measures. The incidence of hospitalization days, ICU stay time, acute renal insufficiency, and new cerebral infarction in the POCD group were higher than those in the non-POCD group ( < 0.001, < 0.001, = 0.001, = 0.029). Univariate and multivariate analysis showed that Hs-CRP was an independent risk factor for POCD in patients undergoing surgery for VHD disease.
Our study shows that preoperative Hs-CRP is significantly elevated in POCD patients undergoing VHD surgery, and preoperative Hs-CRP is an independent predictor of POCD.
术后认知功能障碍（POCD）与心脏手术的不良结局相关。本研究调查了术前超敏C反应蛋白（Hs-CRP）作为瓣膜性心脏病（VHD）患者POCD预后指标的可能性。
本研究回顾性分析了2024年1月至2024年7月在福建医科大学附属协和医院心脏外科住院的372例VHD患者。通过术前和术后1个月的神经心理学检查评估POCD。收集人口统计学、病史、血液生化参数和围手术期数据。根据POCD的发生情况，将患者分为POCD组（N = 103）和非POCD组（N = 269）。采用逻辑回归模型分析VHD患者中Hs-CPR与POCD的关系。
VHD患者POCD的1个月发生率为27.6%。两组间年龄和受教育年限有统计学意义（= 0.047，= 0.001）。POCD组的红细胞计数低于非POCD组（= 0.025），POCD组的Hs-CRP和机械通气时间高于非POCD组，具有统计学意义（< 0.001）。在人口统计学特征和其他实验室指标结果方面未观察到显著差异。POCD组的住院天数、ICU停留时间、急性肾功能不全和新发脑梗死的发生率高于非POCD组（< 0.001，< 0.001，= 0.001，= 0.029）。单因素和多因素分析表明，Hs-CRP是VHD疾病手术患者POCD的独立危险因素。
我们的研究表明，接受VHD手术的POCD患者术前Hs-CRP显著升高，术前Hs-CRP是POCD的独立预测指标。
