Yang F, Zhou RJ, Xu W, Li Y, Luan DH, Xu MY. Value of inflammatory markers in predicting psychotic complications of postoperative depression after cerebrovascular intervention. World J Psychiatry 2026; 16(6): 116328 [DOI: 10.5498/wjp.v16.i6.116328]
Corresponding Author of This Article
Ming-Yang Xu, Research Fellow, Department of Neurology, Yangzhou University Affiliated Taixing Hospital, No. 1 Changzheng Road, Taixing 225400, Jiangsu Province, China. xumingyang860624@126.com
Research Domain of This Article
Psychiatry
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research-article
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Yang F, Zhou RJ, Xu W, Li Y, Luan DH, Xu MY. Value of inflammatory markers in predicting psychotic complications of postoperative depression after cerebrovascular intervention. World J Psychiatry 2026; 16(6): 116328 [DOI: 10.5498/wjp.v16.i6.116328]
Feng Yang, Ru-Juan Zhou, Wu Xu, Yan Li, Dong-Heng Luan, Ming-Yang Xu, Department of Neurology, Yangzhou University Affiliated Taixing Hospital, Taixing 225400, Jiangsu Province, China
Author contributions: Yang F was responsible for the conceptualization, methodology, investigation, formal analysis, and writing of the original draft; Zhou RJ contributed to the investigation and data curation; Xu W undertook the validation work for the study; Li Y was in charge of securing the resources required for this research; Luan DH handled the visualization of the study findings; Xu MY oversaw the supervision of the study, acquisition of funding, the review and editing of the manuscript; and all authors thoroughly reviewed and endorsed the final manuscript.
AI contribution statement: The authors declare that no AI tools were used in the development or writing of this manuscript and take full responsibility for its integrity, accuracy, and originality.
Supported by China International Medical Foundation “Cerebrovascular Disease Youth Innovation Fund”, No. Z-2016-20-2201.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Yangzhou University Affiliated Taixing Hospital, No. K-W2023015.
Informed consent statement: All study participants and their legal guardians provided written informed consent prior to study enrolment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Corresponding author: Ming-Yang Xu, Research Fellow, Department of Neurology, Yangzhou University Affiliated Taixing Hospital, No. 1 Changzheng Road, Taixing 225400, Jiangsu Province, China. xumingyang860624@126.com
Received: December 5, 2025 Revised: January 8, 2026 Accepted: March 4, 2026 Published online: June 19, 2026 Processing time: 174 Days and 0.8 Hours
Abstract
BACKGROUND
Post-intervention depression with psychotic features represents a severe complication in cerebrovascular intervention that substantially impedes recovery and quality of life. Growing evidence implicates neuroinflammation as a key pathophysiological mechanism linking procedural stress, ischemia-reperfusion injury, and the development of post-procedural neuropsychiatric sequelae. Identifying reliable biomarkers for early risk stratification is crucial for preemptive management.
AIM
To investigate the value of human chitinase-3-like protein 1 (YKL-40/CHI3L1), high-sensitivity C-reactive protein, and interleukin-6 in predicting psychotic complications of postoperative depression following cerebrovascular intervention.
METHODS
General patient data from 94 patients who underwent cerebrovascular intervention and serum levels of YKL-40, high-sensitivity C-reactive protein, and interleukin-6 measured preoperatively and on postoperative day 1, days 3, and days 7 were collected and compared between the two groups. Multivariate logistic regression identified independent risk factors for psychotic complications. Receiver operating characteristic curve analysis evaluated the predictive efficacy of each inflammatory marker, and the correlation between inflammatory marker levels and psychiatric assessment scale scores was analyzed.
RESULTS
Univariate and multivariate logistic regression analyses identified YKL-40 levels on postoperative day 3, National Institute of Health Stroke Scale scores on postoperative day 7, and intraoperative complications as independent risk factors for postoperative depressive disorder with psychotic complications (P < 0.05). Receiver operating characteristic curve analysis indicated that the inflammatory markers measured on postoperative day 3 had the highest predictive value. Among them, YKL-40 had the largest area under the curve of 0.892 (95% confidence interval: 0.821-0.963), with an optimal cut-off value of 156.4 ng/mL, yielding a sensitivity of 85.7% and a specificity of 84.8%. Spearman correlation analysis revealed that YKL-40 levels on postoperative day 3 in the complication group were significantly positively correlated with both Hamilton Depression Rating Scale-17 scores (r = 0.612, P < 0.001) and Positive and Negative Syndrome Scale positive subscale scores (r = 0.584, P < 0.001).
CONCLUSION
YKL-40 demonstrated good predictive efficacy for psychotic complications of depression following cerebrovascular intervention. Dynamic monitoring of YKL-40 can facilitate early identification of high-risk patients and enable timely, effective interventions.
Core Tip: This article of 94 patients undergoing cerebrovascular intervention identified postoperative day 3 serum human chitinase-3-like protein 1 level, postoperative day 7 National Institute of Health Stroke Scale score, and intraoperative complications as independent risk factors for depressive disorder with psychotic complications. Human chitinase-3-like protein 1 demonstrated superior predictive value (area under the curve = 0.892) compared to interleukin-6 and high-sensitivity C-reactive protein, and its levels correlated significantly with Hamilton Depression Rating Scale-17 and Positive and Negative Syndrome Scale positive subscale scores, highlighting its potential as a robust biomarker for early identification of high-risk patients.
