Abstract：
BACKGROUND: POCD is a common complication among patients who underwent coronary artery bypass graft (CABG), it is linked to loss of independence and reduced quality of life.
OBJECTIVE: To examine the association between postoperative cognitive dysfunction (POCD), postoperative delirium (POD) and interleukin-6 (IL-6).
METHODS: A prospective cohort study.
METHODS: Patients who underwent elective isolated CABG were enrolled. POCD was assessed by a set of cognitive function tools. Delirium was assessed using the CAM-ICU. The logistic regression analyses were used to identify the predictive value of POD or IL-6 on POCD. The path analysis was used to analyse the relationship among POD, IL-6 and POCD.
RESULTS: A total of 212 patients were enrolled, with 25.0% of patients developing POD and 32.5% developing POCD. The multiple logistic regression analysis revealed that patients with POD had a four-fold increased hazard of POCD (OR = 3.655), and patients with IL-6 ≥ 830.50 pg/mL at the 6th hours after surgery had a 5-fold increased risk of experiencing POCD (OR = 5.042). However, the mediation effect of POD between IL-6 and POCD was not statistically significant (β = 0.059, p = .392).
CONCLUSIONS: POD and IL-6 at the 6th hour after surgery (≥830.50 pg/mL) are two potent predictors for POCD, while POD did not play a mediation effect between IL-6 and POCD.
CONCLUSIONS: Early identification of risk factors (e.g., delirium assessment and testing for serum IL-6 levels) by clinical nurses for POCD may contribute to the clinical practice for the targeted prevention nursing strategies.
OBJECTIVE: To examine the association between postoperative cognitive dysfunction (POCD), postoperative delirium (POD) and interleukin-6 (IL-6).
METHODS: A prospective cohort study.
METHODS: Patients who underwent elective isolated CABG were enrolled. POCD was assessed by a set of cognitive function tools. Delirium was assessed using the CAM-ICU. The logistic regression analyses were used to identify the predictive value of POD or IL-6 on POCD. The path analysis was used to analyse the relationship among POD, IL-6 and POCD.
RESULTS: A total of 212 patients were enrolled, with 25.0% of patients developing POD and 32.5% developing POCD. The multiple logistic regression analysis revealed that patients with POD had a four-fold increased hazard of POCD (OR = 3.655), and patients with IL-6 ≥ 830.50 pg/mL at the 6th hours after surgery had a 5-fold increased risk of experiencing POCD (OR = 5.042). However, the mediation effect of POD between IL-6 and POCD was not statistically significant (β = 0.059, p = .392).
CONCLUSIONS: POD and IL-6 at the 6th hour after surgery (≥830.50 pg/mL) are two potent predictors for POCD, while POD did not play a mediation effect between IL-6 and POCD.
CONCLUSIONS: Early identification of risk factors (e.g., delirium assessment and testing for serum IL-6 levels) by clinical nurses for POCD may contribute to the clinical practice for the targeted prevention nursing strategies.
摘要：
背景：POCD是冠状动脉旁路移植术（CABG）患者的常见并发症，它与丧失独立性和生活质量下降有关。
目的：研究术后认知功能障碍（POCD）与术后谵妄（POD）和白细胞介素-6（IL-6）。
方法：前瞻性队列研究。
方法：纳入接受选择性分离CABG的患者。POCD通过一组认知功能工具进行评估。使用CAM-ICU评估谵妄。Logistic回归分析用于确定POD或IL-6对POCD的预测价值。采用通径分析法分析了POD、POD之间的关系。IL-6和POCD。
结果：共纳入212例患者，25.0%的患者发展为POD，32.5%的患者发展为POCD。多因素logistic回归分析显示POD患者POCD风险增加4倍(OR=3.655),术后6小时IL-6≥830.50pg/mL的患者发生POCD的风险增加5倍(OR=5.042).然而,POD在IL-6和POCD之间的中介效应无统计学意义(β=0.059,p=.392).
结论：POD和IL-6在术后6小时（≥830.50pg/mL）是两种有效的POCD预测因子，而POD在IL-6和POCD之间不发挥中介作用。
结论：风险因素的早期识别(例如，临床护士对POCD的谵妄评估和血清IL-6水平的检测）可能有助于临床实践中针对性的预防护理策略。
目的：研究术后认知功能障碍（POCD）与术后谵妄（POD）和白细胞介素-6（IL-6）。
方法：前瞻性队列研究。
方法：纳入接受选择性分离CABG的患者。POCD通过一组认知功能工具进行评估。使用CAM-ICU评估谵妄。Logistic回归分析用于确定POD或IL-6对POCD的预测价值。采用通径分析法分析了POD、POD之间的关系。IL-6和POCD。
结果：共纳入212例患者，25.0%的患者发展为POD，32.5%的患者发展为POCD。多因素logistic回归分析显示POD患者POCD风险增加4倍(OR=3.655),术后6小时IL-6≥830.50pg/mL的患者发生POCD的风险增加5倍(OR=5.042).然而,POD在IL-6和POCD之间的中介效应无统计学意义(β=0.059,p=.392).
结论：POD和IL-6在术后6小时（≥830.50pg/mL）是两种有效的POCD预测因子，而POD在IL-6和POCD之间不发挥中介作用。
结论：风险因素的早期识别(例如，临床护士对POCD的谵妄评估和血清IL-6水平的检测）可能有助于临床实践中针对性的预防护理策略。
