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Establish a Nomogram of Cardiac Postoperative Cognitive Dysfunction.

Naxin Xie1, Sunang Yan1, Xuejun Sun1

  • 1Department of Cardiovascular Surgery, Fujian Medical University Affiliated First Quanzhou Hospital, Quanzhou, China.

The Heart Surgery Forum
|April 2, 2021
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Summary

This study developed a nomogram to predict cardiac postoperative cognitive dysfunction (c-POCD) risk using key factors like cardiopulmonary bypass time and hypertension. Early identification aids in preventing c-POCD in high-risk patients.

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Area of Science:

  • Cardiology
  • Neuroscience
  • Surgical Outcomes

Background:

  • Cardiac postoperative cognitive dysfunction (c-POCD) is a frequent complication following cardiac surgery.
  • Early identification and management of patients at high risk for c-POCD are crucial for improving patient outcomes.

Purpose of the Study:

  • To establish a predictive nomogram for cardiac postoperative cognitive dysfunction (c-POCD).
  • To identify independent risk factors for c-POCD using preoperative and intraoperative data.
  • To facilitate early intervention and prevention strategies for c-POCD.

Main Methods:

  • A cohort of 265 patients undergoing cardiac surgery was analyzed.
  • Univariate and multivariate regression analyses were performed to identify risk factors.
  • A nomogram was constructed based on independent risk factors and internally validated.

Main Results:

  • Cardiopulmonary bypass (CPB) time, hypertension, white blood cell (WBC) count, aspartate aminotransferase (AST), and arrhythmia were identified as independent risk factors for c-POCD.
  • The developed nomogram demonstrated a good predictive performance with an initial C-index of 0.8182 and a corrected C-index of 0.793 after internal validation.
  • The model's area under the ROC curve was 0.8188, indicating robust discriminative ability.

Conclusions:

  • A validated nomogram incorporating CPB time, hypertension, WBC count, AST, and arrhythmia effectively predicts the risk of c-POCD.
  • This tool aids in the early identification of high-risk patients, enabling timely management and prevention of c-POCD.
  • The nomogram shows a good forecasting effect and clinical utility for risk stratification in cardiac surgery patients.