Ani Zhao, Yanchun Peng, Lingyu Lin, Liangwan Chen, Yanjuan Lin
{"title":"The influencing factors of cognitive dysfunction in patients after cardiac surgery and the construction of a nomogram prediction model.","authors":"Ani Zhao, Yanchun Peng, Lingyu Lin, Liangwan Chen, Yanjuan Lin","doi":"10.1186/s40001-025-02949-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Early detection of cognitive dysfunction (POCD) in patients undergoing cardiac surgery may help improve the prognosis and quality of life. Identifying risk factors and clinically relevant factors is critical for prevention and treatment.</p><p><strong>Methods: </strong>This study retrospectively selected 305 patients admitted to the cardiac surgery Department of Union Hospital Affiliated with Fujian Medical University from January 2024 to July 2024 as the study objects. The cognitive function of the patients was assessed by the Montreal Cognitive Assessment Scale (MOCA) before and on the 6th day after surgery, and the patients were divided into a cognitive dysfunction group and a non-cognitive dysfunction group. Logistic regression was used to analyze the risk factors of POCD in patients undergoing cardiac surgery. R software was used to construct the nomogram model of POCD in heart patients.</p><p><strong>Results: </strong>Logistic regression model was used to screen the included variables, and the final results showed age (OR = 2.670, 95%CI 1.675-4.255, P < 0.001), white blood cell count (OR = 1.155, 95%CI 1.050-1.271, P = 0.009), lymphocytes (OR = 2.200, 95%CI 1.512-3.200, P < 0.001), and hemoglobin (OR = 1.020, 95%CI 1.009-1.032, P < 0.001) were independent risk factors for POCD on day 6 in patients undergoing cardiac surgery. The predicted value of the calibration curve of POCD on the 6th day of cardiac surgery was consistent with the actual value, and the Hosmer-Lemeshow goodness-of-fit test (χ<sup>2</sup> = 8.73, P = 0.36 > 0.05) showed good consistency. The area under the ROC curve is 0.80, with a good differentiation and decision curve.</p><p><strong>Conclusions: </strong>Age, white blood cell count, lymphocyte, and hemoglobin are independent risk factors for POCD on day 6 of cardiac surgery. The nomogram prediction model constructed in this study has good predictive ability.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"925"},"PeriodicalIF":3.4000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Medical Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s40001-025-02949-x","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Early detection of cognitive dysfunction (POCD) in patients undergoing cardiac surgery may help improve the prognosis and quality of life. Identifying risk factors and clinically relevant factors is critical for prevention and treatment.
Methods: This study retrospectively selected 305 patients admitted to the cardiac surgery Department of Union Hospital Affiliated with Fujian Medical University from January 2024 to July 2024 as the study objects. The cognitive function of the patients was assessed by the Montreal Cognitive Assessment Scale (MOCA) before and on the 6th day after surgery, and the patients were divided into a cognitive dysfunction group and a non-cognitive dysfunction group. Logistic regression was used to analyze the risk factors of POCD in patients undergoing cardiac surgery. R software was used to construct the nomogram model of POCD in heart patients.
Results: Logistic regression model was used to screen the included variables, and the final results showed age (OR = 2.670, 95%CI 1.675-4.255, P < 0.001), white blood cell count (OR = 1.155, 95%CI 1.050-1.271, P = 0.009), lymphocytes (OR = 2.200, 95%CI 1.512-3.200, P < 0.001), and hemoglobin (OR = 1.020, 95%CI 1.009-1.032, P < 0.001) were independent risk factors for POCD on day 6 in patients undergoing cardiac surgery. The predicted value of the calibration curve of POCD on the 6th day of cardiac surgery was consistent with the actual value, and the Hosmer-Lemeshow goodness-of-fit test (χ2 = 8.73, P = 0.36 > 0.05) showed good consistency. The area under the ROC curve is 0.80, with a good differentiation and decision curve.
Conclusions: Age, white blood cell count, lymphocyte, and hemoglobin are independent risk factors for POCD on day 6 of cardiac surgery. The nomogram prediction model constructed in this study has good predictive ability.
期刊介绍:
European Journal of Medical Research publishes translational and clinical research of international interest across all medical disciplines, enabling clinicians and other researchers to learn about developments and innovations within these disciplines and across the boundaries between disciplines. The journal publishes high quality research and reviews and aims to ensure that the results of all well-conducted research are published, regardless of their outcome.