Postoperative depression and anxiety in patients undergoing intestinal tumor surgery: Incidence, predictors, and impact on quality of life
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Postoperative depression and anxiety among patients with intestinal tumor surgery are closely related to inflammation and nutritional imbalance, which in turn, can affect quality of life. AIM: To systematically evaluate the occurrence regularity of depression and anxiety, predictive factors, and dynamic effects on the quality of life of patients after intestinal tumor surgery, to provide a basis for clinical psychological intervention. METHODS: days after surgery to assess the psychological state, and the 36-Item Short-Form (SF-36) scale was used to assess the quality of life. The inflammation index [neutrophil-to-lymphocyte ratio (NLR) and albumin-to-fibrinogen ratio (AFR)] and nutrition index were measured simultaneously. Statistical analysis was performed using a mixed-effects model, intermediary analysis, and XGBoost algorithm. RESULTS: < 0.05). The XGBoost model identified hypotension during surgery, postoperative high NLR (> 7.0), and low AFR (< 12.0) as key predictors, with an area under the curve (AUC) of 0.873. The external validation AUC of the XGBoost model was 0.826 (95%CI: 0.775-0.877), with a critical value of 0.612, sensitivity of 78.3%, and specificity of 75.6%. These core predictive factors were consistent with those identified in the original study. CONCLUSION: Psychological disorders after surgery for intestinal tumors are closely related to inflammation activation and nutritional imbalance, and are most significant in the early postoperative period. Intraoperative hypotension and postoperative NLR/AFR abnormalities are strong predictors of psychological risks. Inflammatory markers also play a key intermediary role in the impact of postoperative psychological disorders on quality of life. We recommend measuring NLR and AFR at 24 hours postoperatively, with intervention thresholds set at NLR > 7.0 and AFR < 12.0. Intraoperative blood pressure should be maintained above 90 mmHg to reduce psychological risks. Importantly, a physical and mental integration rehabilitation model should be implemented.
Authors: Zhi-Jian Wei, Pei-Pei Liang, A-Man Xu
Language: English
Topic: Cancer survivorship and care
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7116114512