Correlation of preoperative inflammatory factors and emotional disorders with postoperative delirium in patients with craniocerebral trauma

Table 1 General data of patients with traumatic brain injury, mean ± SD/n (%)

Index	POD group (n = 21)	Non-POD group (n = 59)	χ2/t	P value
Age (year)	50.48 ± 8.53	47.88 ± 8.62	1.188	0.239
Sex			0.111	0.738
Male	16 (76.19)	47 (79.66)
Female	5 (23.81)	12 (20.34)
BMI (kg/m2)	22.08 ± 2.23	22.50 ± 2.76	0.631	0.530
Time from trauma to admission (minutes)	85.10 ± 15.51	83.39 ± 12.13	0.513	0.609
Admission GCS score (score)			7.770	0.005
≤ 3	10 (47.62)	10 (16.95)
> 3	11 (52.38)	49 (83.05)
Intracranial pressure at admission (mmHg)	52.95 ± 10.73	49.85 ± 10.73	1.139	0.258
Pupil changes			4.195	0.041
Single side scattered	7 (33.33)	35 (59.32)
Bilateral scattered	14 (66.67)	24 (40.68)
Prehemorrhagic shock			6.792	0.009
Yes	11 (52.38)	13 (22.03)
No	10 (47.62)	46 (77.97)
Hematoma volume (mL)	55.95 ± 12.36	53.49 ± 11.55	0.823	0.413
Midline shift			1.566	0.211
< 10 mm	7 (33.33)	29 (49.15)
≥ 10 mm	14 (66.67)	30 (50.85)
Preoperative drilling and drainage			0.007	0.934
Yes	18 (85.71)	52 (88.14)
No	3 (14.29)	7 (11.86)
Ventricular hemorrhage			3.975	0.046
Yes	7 (33.33)	8 (13.56)
No	14 (66.67)	51 (86.44)
Compressed ring pool			0.132	0.717
Compressed unilateral ring pool	9 (42.86)	28 (47.46)
Compressed bilateral ring pool	12 (57.14)	31 (52.54)
Postoperative high glucose hyperpermeability			8.366	0.004
Yes	8 (38.10)	6 (10.17)
No	13 (61.90)	53 (89.83)

POD: Postoperative delirium; BMI: Body mass index; GCS: Glasgow Coma Scale.

Table 2 Preoperative levels of inflammatory factors in both groups, mean ± SD

Index	POD group (n = 21)	non-POD group (n = 59)	t value	P value
IL-6	21.62 ± 5.68	16.78 ± 4.22	4.105	< 0.05
TNF-α	65.71 ± 14.19	56.19 ± 12.18	2.948	0.004
MPO	132.24 ± 17.01	115.19 ± 18.09	3.640	< 0.05

POD: Postoperative delirium; IL-6: Interleukin-6; TNF-α: Tumor necrosis factor-α; MPO: Myeloperoxidase.

Table 3 Variable assignments

Index	Assignment
POD circumstances	1 = POD, 0 = non-POD
Admission GCS score	1 = ≤ 3, 0 = > 3
Pupil changes	1 = Bilateral scattered, 0 = Single side scattered
Prehemorrhagic shock	1 = yes, 0 = no
Ventricular hemorrhage	1 = yes, 0 = no
Postoperative high glucose hyperpermeability	1 = yes, 0 = no
IL-6	1 = ≥17.5, 0 = < 17.5
TNF-α	1 = ≥ 64.5, 0 = < 64.5
MPO	1 = ≥ 132.5, 0 = < 132.5
HAMA	1 = ≥ 7, 0 = < 7
HAMD	1 = ≥ 7, 0 = < 7

POD: Postoperative delirium; GCS: Glasgow Coma Scale; IL-6: Interleukin-6; TNF-α: Tumor necrosis factor-α; MPO: Myeloperoxidase; HAMD: Hamilton Depression Scale; HAMA: Hamilton Anxiety Scale.

Table 4 Multivariate logistic regression analysis

Index	B	SE	Wald χ2	P value	OR	95%CI
Admission GCS score	2.232	1.058	4.453	0.035	9.321	1.172-74.105
Pupil changes	1.060	0.955	1.230	0.267	2.886	0.444-18.770
Prehemorrhagic shock	1.365	1.109	1.516	0.218	3.918	0.446-34.444
Ventricular hemorrhage	2.878	1.151	6.249	0.012	17.777	1.862-169.742
Postoperative high glucose hyperpermeability	1.123	1.366	0.676	0.411	3.075	0.211-44.755
IL-6	2.538	1.104	5.291	0.021	12.659	1.456-110.082
TNF-α	2.344	1.062	4.867	0.027	10.421	1.299-83.616
MPO	0.713	1.108	0.414	0.520	2.039	0.233-17.887
HAMA	2.127	1.020	4.349	0.037	8.394	1.137-61.993
HAMD	2.421	1.081	5.011	0.025	11.256	1.352-93.735

GCS: Glasgow Coma Scale; IL-6: Interleukin-6; TNF-α: Tumor necrosis factor-α; MPO: Myeloperoxidase; HAMD: Hamilton Depression Scale; HAMA: Hamilton Anxiety Scale.