Retrospective analysis cognitive function changes in elderly depressive patients after gastrointestinal tumor surgery and exploration of cholinergic mechanism

Table 1 Univariate analysis of post-operative cognitive dysfunction in older patients with depression after surgery for a gastrointestinal tumor, n (%)

Variable	POCD group (n = 35)	Non-POCD group (n = 60)	t/χ2/Z	P value
Age (years)	75.2 ± 4.9	70.8 ± 5.6	-3.892	< 0.001
Male sex	18 (51.4)	34 (56.7)	0.256	0.613
BMI (kg/m2)	22.8 ± 3.5	23.3 ± 3.0	0.734	0.465
Education (year)	7.6 ± 3.5	9.0 ± 3.9	1.822	0.072
ASA grade (II/III)	20/15	43/17	1.438	0.230
Pre-operative HAMD score	21.1 ± 3.8	17.0 ± 3.9	-5.063	< 0.001
Pre-operative MMSE score	26.5 ± 1.6	27.0 ± 1.4	1.583	0.117
Pre-operative MoCA score	23.8 ± 2.3	24.5 ± 1.9	1.621	0.108
Hypertension	24 (68.6)	34 (56.7)	1.359	0.244
Diabetes	14 (40.0)	17 (28.3)	1.441	0.230
Tumor site (gastric/colorectal)	17/18	24/36	0.383	0.536
TNM stage (I-II/III)	19/16	40/20	1.186	0.276
Laparoscopic approach	22 (62.9)	45 (75.0)	1.655	0.198
Duration of surgery (minute)	205.7 ± 48.1	169.2 ± 38.5	-4.052	< 0.001
Intra-operative blood loss (mL)	200 (150, 250)	120 (80, 180)	-4.125	< 0.001
Intra-operative anticholinergic use	17 (48.6)	11 (18.3)	9.952	0.002
24-hour post-operative VAS score	5.1 ± 1.1	4.2 ± 1.1	-3.852	< 0.001
Post-operative infection	9 (25.7)	6 (10.0)	4.183	0.041
Pre-operative IL-6 (pg/mL)	5.6 [4.1, 7.8]	4.3 [2.9, 5.7]	-2.891	0.004
Post-operative IL-6 (pg/mL)	42.3 [31.5, 55.2]	20.1 [15.3, 28.4]	-5.234	< 0.001
Pre-operative TNF-α (pg/mL)	7.1 [5.6, 9.3]	5.7 [4.3, 7.2]	-2.456	0.014
Post-operative TNF-α (pg/mL)	26.8 [19.4, 35.7]	13.8 [9.6, 19.2]	-4.987	< 0.001
Pre-operative CHE (U/L)	6 450 ± 1 380	7 080 ± 1 150	2.345	0.021
Post-operative CHE (U/L)	4 520 ± 1 280	5 820 ± 1 360	4.892	< 0.001
IL-6 change (%)	655.4 ± 189.3	367.4 ± 120.6	-8.123	< 0.001
TNF-α change (%)	277.6 ± 95.8	142.1 ± 63.5	-7.856	< 0.001
CHE change (%)	-29.8 ± 10.2	-17.8 ± 6.9	-6.234	< 0.001

POCD: Post-operative cognitive dysfunction; BMI: Body mass index; ASA: American Society of Anesthesiologists; HAMD: Hamilton Depression Rating Scale; MMSE: Mini-Mental State Examination; MoCA: Montreal Cognitive Assessment; VAS: Visual Analog Scale; IL-6: Interleukin-6; TNF-α: Tumor necrosis factor-alpha; CHE: Cholinesterase.