Correlation Analysis of the Pindicator of PNI,SII of Reoperative Immunological  and Postoperative Delirium in Patients Undergoing Thoracoscopic Surgery

Objective: To explore the relationship between preoperative nutritional index (PNI) and systemic immune inflammatory index (SII) levels and postoperative delirium (POD) in patients undergoing thoracoscopic surgery, and explore the risk factorsfor POD during thoracoscopic surgery. Methods: This study selected 106 patients who underwent thoracoscopic surgery under general anesthesia at a tertiary hospital. One day before surgery, the Mini Mental State Evaluation Scale (MMSE) was used to evaluate the preoperative cognitive function of surgical patients. The results of the patient's last preoperative laboratory examination were recorded, and preoperative PNI and SII levels were calculated. On the first to third day aftersurgery, four rapid delirium diagnosis protocols (4AT) were used daily to evaluate the occurrence of POD in patients. Based on whether POD occurred, patients were divided into delirium group (POD group) and non delirium group (NPOD group), with 23 casesin the POD group and 65 casesin the NPOD group. Observing the incidence of POD after thoracoscopic surgery, comparing the clinical characteristics and preoperative laboratory test results of two groups of patients, using multivariate logistic regression method to analyze the independent risk factors for POD in patients, drawing receiver operating characteristic (ROC) curves, calculating the product under the ROC curve (AUC), and analyzing the predictive value of preoperative PNI and SIIlevelsfor POD in thoracoscopic surgery patients. Results: 1. The preoperative PNI levels of patients in the POD group were significantly lower than those in the NPOD group (P < 0.05), while the preoperative SII levels of patients in the POD group were significantly higherthan those in the NPOD group (P < 0.05). 2. preoperative PNI and SII levels have certain predictive value for POD in patients undergoing thoracoscopic surgery. Conclusions: Increasing age, decreasing preoperative PNI level and increasing preoperative SII level were independent risk factors and effective predictors of POD in patients undergoing thoracoscopic surgery.