[Perioperative Neurocognitive Disorders in Patients With Colorectal Cancer Undergoing General Anesthesia: Influencing...

To develop a risk prediction model for perioperative neurocognitive disorders (PND) in patients with colorectal cancer undergoing general anesthesia based on a nomogram.

A total of 207 patients undergoing colorectal cancer surgery under general anesthesia from August 2021 to December 2024 were enrolled and randomly divided into a modeling cohort (n = 145) and a validation cohort (n = 62) at a 7∶3 ratio. Based on the occurrence of PND, the modeling cohort was further divided into PND group (n = 42) and non-PND group (n = 103), while the validation cohort was divided into PND group (n = 18) and non-PND group (n = 44). Logistic regression analysis was performed to identify influencing factors for PND in patients with colorectal cancer undergoing general anesthesia, and a nomogram prediction model was constructed. Receiver operating characteristic (ROC) curves and calibration curves were plotted, and Hosmer-Lemeshow goodness-of-fit test was conducted.

Univariate analysis showed statistically significant differences between PND group and non-PND group in age, operative time, anesthesia depth, intraoperative blood loss, intraoperative mean regional brain oxygen saturation (rSO₂), mean platelet volume (MPV), platelet distribution width (PDW), visual analog scale (VAS) for pain, and Pittsburgh Sleep Quality Index (PSQI) (P < 0.05). Multivariate Logistic regression analysis revealed that age, anesthesia depth, intraoperative mean rSO₂, MPV, PDW, VAS, and PSQI were all influencing factors for PND in patients with colorectal cancer undergoing general anesthesia (P < 0.05). The area under the ROC curve (AUC) of the nomogram model was 0.861 (95% CI: 0.786-0.935) in the modeling cohort and 0.827 (95% CI: 0.752-0.902) in the validation cohort. Calibration curve analysis indicated that the predicted risk of PND was largely consistent with the actual incidence, and the Hosmer-Lemeshow test showed good model fit. Clinical decision curve analysis demonstrated high clinical applicability of the model.

Advanced age, excessively light anesthesia depth, low intraoperative mean rSO₂, elevated serum MPV and PDW, severe pain, and poor sleep quality are influencing factors for PND in patients with colorectal cancer undergoing general anesthesia. The nomogram model established based on these factors exhibits good predictive performance.