Electroencephalogram-guided anesthesia and postoperative anxiety and depression in elderly gastric cancer patients with sleep disorders

Table 2 Multivariate analysis results for postoperative psychological outcomes

Variable	Odds ratio	95%CI	P value
Protective factors
Electroencephalogram-guided individualized anesthesia	0.56	0.41-0.78	0.003
Reasonable preoperative psychological preparation	0.65	0.45-0.94	0.022
Good postoperative pain control (resting Visual Analog Scale < 4)	0.74	0.53-1.02	0.067
Risk factors
Preoperative psychological factors
Preoperative Hospital Anxiety and Depression Scale score ≥ 8	2.15	1.42-3.26	< 0.001
Preoperative PSQI score ≥ 10	1.87	1.26-2.78	0.002
Individual PSQI components
Poor sleep efficiency (≤ 75%)	2.24	1.48-3.39	< 0.001
Frequent sleep disturbances (≥ 2.5 points)	1.95	1.32-2.88	0.001
Patient-related factors
Age ≥ 75 years	1.43	1.02-2.01	0.038
American Society of Anesthesiologists III	1.39	0.97-1.98	0.072
Intraoperative factors
Intraoperative hypotension	1.75	1.18-2.61	0.006
Operation time > 3 hours	1.68	1.13-2.49	0.010
Intraoperative blood loss > 300 mL	1.52	1.06-2.17	0.021
Intraoperative temperature < 36.0 °C	1.46	1.05-2.03	0.024

Variables with P ≥ 0.05 indicate non-significant trends. The analysis included individual Pittsburgh Sleep Quality Index components to identify specific sleep disorder patterns most predictive of postoperative psychological outcomes. PSQI: Pittsburgh Sleep Quality Index.