Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Jul 19, 2024; 14(7): 1043-1052
Published online Jul 19, 2024. doi: 10.5498/wjp.v14.i7.1043
Correlation of preoperative inflammatory factors and emotional disorders with postoperative delirium in patients with craniocerebral trauma
Peng Cao, Zhe-Yong Jia, Tao Zheng, Tao Mei
Peng Cao, Zhe-Yong Jia, Tao Zheng, Tao Mei, Department of Neurosurgery, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde 415003, Hunan Province, China
Author contributions: Cao P wrote the manuscript; Jia ZY and Zheng T analyzed the data; Mei T was responsible for revising the manuscript for important intellectual content; all authors read and approved the final version.
Supported by Hunan Provincial Natural Science Foundation of China, No. 2021JJ70001.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City).
Informed consent statement: All study participants or their legal guardians provided written informed consent for personal and medical data collection before study enrollment.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: The data used in this study can be obtained from the corresponding author upon request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tao Mei, MM, Chief Physician, Department of Neurosurgery, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), No. 818 Renmin Road, Wuling District, Changde 415003, Hunan Province, China. meitao197511@126.com
Received: April 10, 2024
Revised: May 14, 2024
Accepted: June 17, 2024
Published online: July 19, 2024
Processing time: 92 Days and 19.2 Hours
Abstract
BACKGROUND

Traumatic brain injury (TBI) imposes a substantial societal and familial burden due to its high disability and fatality rates, rendering it a serious public health problem. Some patients with TBI have poor treatment outcomes and are prone to postoperative delirium (POD), which affects their quality of life. Anxiety has been linked to increased POD incidence in some studies, while others have found no correlation.

AIM

To investigate the correlation of POD risk factors, preoperative inflammatory factors, and mood disorders in patients with TBI.

METHODS

We retrospectively collected data on the treatment of 80 patients with TBI from November 2021 to September 2023. Patients were grouped as POD and non-POD, according to their POD status, and the general data of the two groups were compared. Inflammatory factor levels were detected preoperatively, and the Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) were used to investigate the risk factors associated with POD in these patients. Logistic regression was used to identify the independent risk factors.

RESULTS

Twenty-one patients (26.25%) developed POD, including 7, 10, and 4 cases of the excitatory, inhibitory, and mixed types, respectively. There were 59 cases (73.75%) in the non-POD group. Compared with the non-POD group, the POD group had a significantly higher proportion of patients with low Glasgow Coma Scale (GCS) scores before admission, unilateral mydriasis, preoperative hemorrhagic shock, intraventricular hemorrhage (IVH), and postoperative hyperglycemic hyperosmolar disease (P < 0.05). In the POD group, interleukin-6 (IL-6), human tumor necrosis factor-α (TNF-α), myeloperoxidase levels, HAMA, and HAMD scores were higher than those in the non-POD group (all P < 0.05). Logistic multivariate analysis showed that GCS score at admission, IVH, IL-6, TNF-α, HAMA, and HAMD were independent risk factors for POD in patients with TBI (P < 0.05).

CONCLUSION

Low GCS score at admission, IVH, elevated IL-6 and TNF-α, other inflammatory indicators, anxiety, and depression, can increase the risk of POD in patients with TBI after surgery.

Keywords: Inflammatory factors, Mood disorders, Traumatic brain injury, Postoperative delirium, Relevance, Risk factor

Core Tip: Traumatic brain injury (TBI) is a common form of trauma caused by external violence, resulting in head and brain injuries. TBI ranks second only to limb injuries in all body regions. It is a complex and severe injury with high disability and mortality rates, often manifesting symptoms such as disturbed consciousness, neurological dysfunction, and increased intracranial pressure, posing significant risks to patient safety. This study examines the risk factors for postoperative delirium (POD) in patients with TBI, aiming to enable early intervention and reduce POD occurrence.