1.Factors related to post-operative delirium in middle-aged and elderly patients in intensive care unit and risk prediction model
Zhangwei GE ; Xin HUANG ; Zhengdong LIU ; Min ZHANG ; Jiakui ZHANG
Chinese Journal of Rehabilitation Theory and Practice 2022;28(3):340-345
Objective To analyze the influencing factors of post-operative delirium (POD) in middle-aged and elderly patients in intensive care unit (ICU) and construct risk prediction model for it.Methods A total of 112 middle-aged and elderly postoperative patients in the ICU of Lu39;an Hospital of Anhui Medical University from January, 2018 to February, 2021 were selected. On the second day after the operation, they were transferred to ICU, and assessed with the Confusion AssessmentMethod for Intensive Care Unit (CAM-ICU). The patients were divided into delirium group (n = 52) and non-delirium group (n = 60) according to assessment. Univariate analysis was used to compare the differences in clinical data between the two groups, and multivariate Logistic regression analysis was used to screen the independent influencing factors to construct risk prediction model. Receiver operating characteristic (ROC) curve was used to evaluate prediction performance. Results Multivariate logistic regression analysis showed Acute Physiology and Chronic Health Evaluation II score (APACHE II score) (OR = 1.424, 95%CI 1.204 to 1.685, P < 0.001), ICU sleep quality score (OR = 1.432, 95%CI 1.159 to 1.770, P < 0.001), and postoperative oxygenation index ≤ 300 (OR = 4.485, 95%CI 1.644 to 12.240, P = 0.001) were independent influencing factors of postoperative delirium in ICU. The prediction model was: logit(P) = -11.381+0.354X1 (APACHE II score, cut-off value 16)+0.359X2 (ICU sleep quality score, cut-off value 13)+1.501X3 (postoperative oxygenation index ≤ 300), with the sensitivity and specificity of 79.2% and 79.7% respectively. The area under the ROC curve was 0.866 (95%CI 0.801 to 0.930), more than those of the factors alone (P < 0.05). Conclusion The prediction model based on Logistic regression can predict the occurrence of postoperative delirium in middle-aged and elderly patients in ICU.
2.Lienal polypeptide injection attenuates lipopolysaccharide-induced acute lung injury in rats by metastasis-associated protein 1
GE Peng ; LI Hanjie ; CHEN Xin ; JING Ruijun ; YAO Yuejuan ; LI Jianzhong ; ZHANG Weidong ; YANG Bo
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2019;26(3):264-268
Objective To analyze the role of lienal polypeptide injection in acute lung injury induced by lipopolysaccharide (LPS) in rats. Methods Eighty male SD rats were randomly allocated into 4 groups: a LPS group, a control group, a lienal polypeptide group and a LPS+ lienal polypeptide group (20 rats in each group). Lienal polypeptide or normal saline was given with an intramuscular injection 30 min after an intraperitoneal injection of LPS (5 mg/kg). The severity of pulmonary injury was evaluated 4 h after LPS challenge by enzyme-linked immunosorbent assay (ELISA), wet-to-dry weight ratio, hematoxylin and eosin (HE) staining, TUNEL and Western blotting. Results Lienal polypeptide injection treatment significantly attenuated LPS-induced pulmonary histopathologic changes, alveolar hemorrhage, and neutrophil infiltration. Moreover lienal polypeptide injection significantly suppressed LPS-induced activation of metastasis-associated protein-1 (MTA1). Conclusion Lienal polypeptide injection is demonstrated to protect rats from LPS-induced acute lung injury by the expression of MTA1.


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