Value of inflammatory markers in predicting psychotic complications of postoperative depression after cerebrovascular intervention

Table 1 Univariate analysis of psychotic complications of postoperative depression after cerebrovascular intervention, n (%)

Variable	Overall (n = 94)	Observation group (n = 28)	Control group (n = 66)	Statistic	P value
Age (years), mean ± SD	64.0 ± 9.3	65.8 ± 8.9	63.1 ± 9.5	t = 1.325	0.188
Male	56 (59.6)	16 (57.1)	40 (60.6)	χ2 = 0.102	0.749
BMI (kg/m2), mean ± SD	23.8 ± 3.0	24.1 ± 2.8	23.7 ± 3.1	t = 0.597	0.552
Hypertension	62 (66.0)	20 (71.4)	42 (63.6)	χ2 = 0.527	0.468
Diabetes	27 (28.7)	9 (32.1)	18 (27.3)	χ2 = 0.231	0.631
Hyperlipidemia	35 (37.2)	12 (42.9)	23 (34.8)	χ2 = 0.536	0.464
Smoking history	38 (40.4)	13 (46.4)	25 (37.9)	χ2 = 0.579	0.447
Alcohol history	31 (33.0)	10 (35.7)	21 (31.8)	χ2 = 0.136	0.712
Preop NIHSS score	4 (2, 7)	6 (4, 9)	3 (1, 5)	Z = 3.891	< 0.001
Preop mRS score ≥ 2	31 (33.0)	14 (50.0)	17 (25.8)	χ2 = 5.432	0.020
Preop HAMD-17 score	5 (3, 7)	6 (4, 8)	4 (2, 6)	Z = 2.987	0.003
Operation duration (minute)	120 (90, 165)	145 (110, 185)	110 (85, 150)	Z = 2.456	0.014
Intraoperative complications	11 (11.7)	7 (25.0)	4 (6.1)	Fisher	0.016
Contrast volume (mL), mean ± SD	145.6 ± 35.2	152.3 ± 38.1	142.5 ± 33.5	t = 1.287	0.201
Postop day 7 NIHSS score	3 (1, 5)	5 (3, 7)	2 (1, 4)	Z = 4.215	< 0.001
Postop day 7 mRS score ≥ 2	48 (51.1)	21 (75.0)	27 (40.9)	χ2 = 9.012	0.003
Preoperative inflammatory markers
hs-CRP (mg/L)	2.0 (1.4, 2.9)	2.1 (1.5, 3.0)	1.9 (1.3, 2.8)	Z = 0.891	0.373
IL-6 (pg/mL)	8.1 (6.0, 10.8)	8.5 (6.1, 11.2)	7.8 (5.9, 10.5)	Z = 0.765	0.444
YKL-40 (ng/mL)	56.3 (43.9, 70.2)	58.3 (45.6, 72.1)	55.1 (42.8, 69.5)	Z = 0.812	0.417
Postop day 1 inflammatory markers
hs-CRP (mg/L)	11.9 (8.5, 15.8)	15.8 (12.1, 20.5)	10.2 (7.5, 13.6)	Z = 4.521	< 0.001
IL-6 (pg/mL)	26.2 (19.5, 34.8)	35.6 (28.4, 45.1)	22.3 (16.8, 29.7)	Z = 5.012	< 0.001
YKL-40 (ng/mL)	96.5 (72.3, 120.8)	125.6 (98.8, 155.3)	85.4 (65.2, 105.7)	Z = 4.876	< 0.001
Postop day 3 inflammatory markers
hs-CRP (mg/L)	14.2 (10.5, 18.9)	18.9 (15.2, 24.1)	12.4 (9.1, 16.0)	Z = 5.234	< 0.001
IL-6 (pg/mL)	33.5 (24.8, 43.1)	48.9 (39.8, 60.5)	28.1 (21.5, 35.9)	Z = 5.678	< 0.001
YKL-40 (ng/mL)	125.6 (92.4, 158.9)	189.5 (160.2, 225.8)	102.8 (80.1, 125.6)	Z = 6.102	< 0.001
Postop day 7 inflammatory markers
hs-CRP (mg/L)	7.5 (5.3, 9.8)	10.5 (7.8, 14.2)	6.3 (4.5, 8.1)	Z = 4.897	< 0.001
IL-6 (pg/mL)	18.2 (13.5, 23.1)	25.3 (19.8, 32.0)	15.1 (11.2, 19.5)	Z = 5.145	< 0.001
YKL-40 (ng/mL)	95.8 (70.1, 120.5)	142.1 (115.4, 175.9)	78.9 (62.3, 98.4)	Z = 5.564	< 0.001

BMI: Body mass index; NIHSS: National Institutes of Health Stroke Scale; mRS: Modified Rankin Scale; HAMD-17: Hamilton Depression Rating Scale-17; hs-CRP: High-sensitivity C-reactive protein; IL-6: Interleukin-6; YKL-40: Human chitinase-3-like protein 1.

Table 2 Multivariate logistic regression analysis of psychotic complications of postoperative depression after cerebrovascular intervention

Variable	β coefficient	SE	Wald χ² value	P value	OR	95%CI for OR
Postop day 3 YKL-40 (per 1 ng/mL increase)	0.018	0.006	9.002	0.003	1.018	1.006-1.030
Postop day 7 NIHSS score (per 1 point increase)	0.421	0.152	7.672	0.006	1.523	1.131-2.051
Intraoperative complications	1.587	0.721	4.844	0.028	4.892	1.192-20.081
Constant	-10.524	2.893	13.241	< 0.001	0.000	-

CI: Confidence interval; OR: Odds ratio; YKL-40: Human chitinase-3-like protein 1; NIHSS: National Institutes of Health Stroke Scale.

Table 3 Receiver operating characteristic curve analysis results of inflammatory markers on postoperative day 3 for predicting complications

Indicator	AUC	95%CI	Optimal cut-off value	Sensitivity (%)	Specificity (%)	P value
YKL-40	0.892	0.821-0.963	156.4 ng/mL	85.7	84.8	< 0.001
IL-6	0.835	0.745-0.925	36.8 pg/mL	82.1	80.3	< 0.001
hs-CRP	0.798	0.698-0.898	15.1 mg/L	78.6	75.8	< 0.001

CI: Confidence interval; AUC: Area under the curve ; YKL-40: Human chitinase-3-like protein 1; IL-6: Interleukin-6; hs-CRP: High-sensitivity C-reactive protein.