{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:45:39Z","timestamp":1791985539693,"version":"4.4.0"},"reference-count":63,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":86,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Doctoral Development Foundation of Lihuili Hospital","award":["2022BSKY-YGF"],"award-info":[{"award-number":["2022BSKY-YGF"]}]},{"name":"the Ningbo Medical Science and Technology Project","award":["2024Y05"],"award-info":[{"award-number":["2024Y05"]}]},{"name":"Key Cultivating Discipline of Lihuili Hospital","award":["2022-PF01"],"award-info":[{"award-number":["2022-PF01"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cardiothorac Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Postoperative delirium is a common complication after cardiac surgery, and perioperative inflammation may contribute to its development. However, the association between preoperative blood indicators and postoperative delirium in patients receiving propofol-based anesthesia remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify preoperative blood indicators associated with postoperative delirium risk in patients undergoing cardiac surgery under propofol-based anesthesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Related data of 694 patients were from MIMIC-IV database. Importance ranking using 2 machine learning algorithms was performed, followed by LASSO regression, multivariable logistic regression, and trend regression analyses to identify the important factors associated with postoperative delirium risk. Receiver operating characteristic curve and decision curve analysis were used to assess their clinical value for predicting delirium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among all patients, 44 patients experienced postoperative delirium (identified via ICD diagnostic coding during hospitalization). Machine learning algorithms initially implied the importance of monocyte in postoperative delirium risk as monocyte ranked first both in 2 algorithms. LASSO regression identified 7 variables, and 4 variables (red cell distribution width, red blood cell, monocyte, sepsis) showed independent association with delirium risk (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05). Further, we found that the risk of delirium was increased with the increase of monocyte level (P for trend\u2009=\u20090.042), particularly when monocyte level exceeded 5.4% (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.037). These results suggested monocyte as a key indicator independently associated with delirium risk and showing the most favorable discriminative performance among the evaluated markers, although its predictive utility requires prospective validation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Preoperative monocyte level was independently associated with coded postoperative delirium in this cohort, but prospective validation is still required before any predictive application.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13019-026-04642-4","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T05:45:03Z","timestamp":1784526303000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of preoperative monocyte level with postoperative delirium in patients receiving cardiac surgery under propofol-based anesthesia: a retrospective study"],"prefix":"10.1186","volume":"21","author":[{"given":"Xuebin","family":"Wen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianbo","family":"Shan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuyu","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gengfan","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihao","family":"Pan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"4642_CR1","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1186\/s12916-014-0141-2","volume":"12","author":"European Delirium A","year":"2014","unstructured":"European Delirium A, American Delirium S. The DSM-5 criteria, level of arousal and delirium diagnosis: inclusiveness is safer. BMC Med. 2014;12:141.","journal-title":"BMC Med"},{"issue":"9\u201310","key":"4642_CR2","doi-asserted-by":"publisher","first-page":"1691","DOI":"10.1111\/jocn.16157","volume":"32","author":"S Kim","year":"2023","unstructured":"Kim S, Choi E, Jung Y, Jang I. Postoperative delirium screening tools for post-anaesthetic adult patients in non-intensive care units: a systematic review and meta-analysis. J Clin Nurs. 2023;32(9\u201310):1691\u2013704.","journal-title":"J Clin Nurs"},{"issue":"4","key":"4642_CR3","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1097\/ANA.0000000000000566","volume":"31","author":"MJ Susano","year":"2019","unstructured":"Susano MJ, Scheetz SD, Grasfield RH, Cheung D, Xu X, Kang JD, et al. Retrospective analysis of perioperative variables associated with postoperative delirium and other adverse outcomes in older patients after spine surgery. J Neurosurg Anesthesiol. 2019;31(4):385\u201391.","journal-title":"J Neurosurg Anesthesiol"},{"issue":"1","key":"4642_CR4","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1503\/cjs.016817","volume":"62","author":"B Saravana-Bawan","year":"2019","unstructured":"Saravana-Bawan B, Warkentin LM, Rucker D, Carr F, Churchill TA, Khadaroo RG. Incidence and predictors of postoperative delirium in the older acute care surgery population: a prospective study. Can J Surg. 2019;62(1):33\u20138.","journal-title":"Can J Surg"},{"issue":"6","key":"4642_CR5","doi-asserted-by":"publisher","first-page":"1966","DOI":"10.1053\/j.jvca.2017.03.042","volume":"31","author":"C Cereghetti","year":"2017","unstructured":"Cereghetti C, Siegemund M, Schaedelin S, Fassl J, Seeberger MD, Eckstein FS, et al. Independent predictors of the duration and overall burden of postoperative delirium after cardiac surgery in adults: an observational cohort study. J Cardiothorac Vasc Anesth. 2017;31(6):1966\u201373.","journal-title":"J Cardiothorac Vasc Anesth"},{"issue":"4 Pt 2","key":"4642_CR6","doi-asserted-by":"publisher","first-page":"e53","DOI":"10.1016\/j.lpm.2018.03.012","volume":"47","author":"KF Rengel","year":"2018","unstructured":"Rengel KF, Pandharipande PP, Hughes CG. Postoperative delirium. Presse Med. 2018;47(4 Pt 2):e53\u201364.","journal-title":"Presse Med"},{"issue":"11","key":"4642_CR7","doi-asserted-by":"publisher","first-page":"776","DOI":"10.1097\/EJA.0000000000000647","volume":"34","author":"S Glumac","year":"2017","unstructured":"Glumac S, Kardum G, Sodic L, Supe-Domic D, Karanovic N. Effects of dexamethasone on early cognitive decline after cardiac surgery: a randomised controlled trial. Eur J Anaesthesiol. 2017;34(11):776\u201384.","journal-title":"Eur J Anaesthesiol"},{"issue":"1","key":"4642_CR8","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1055\/s-0040-1710572","volume":"42","author":"MF Mart","year":"2021","unstructured":"Mart MF, Williams Roberson S, Salas B, Pandharipande PP, Ely EW. Prevention and management of delirium in the intensive care unit. Semin Respir Crit Care Med. 2021;42(1):112\u201326.","journal-title":"Semin Respir Crit Care Med"},{"key":"4642_CR9","doi-asserted-by":"crossref","unstructured":"Sarah LB, Lena SG, Amelia RG, Andrew TG. Cervical Cancer Screening: Past, Present, and Future. Sex Med Rev. 2019;8(1):28\u201337.","DOI":"10.1016\/j.sxmr.2019.09.005"},{"key":"4642_CR10","doi-asserted-by":"crossref","unstructured":"Ru L, Chunyun X, Hengrui L, Yujie H, James PD, Jun L. Effects of local anesthetics on breast cancer cell viability and migration. BMC Cancer. 2018;18(1):666.","DOI":"10.1186\/s12885-018-4576-2"},{"key":"4642_CR11","doi-asserted-by":"crossref","unstructured":"Ru L, Hengrui L, James PD, Jun L. Effect of Propofol on breast Cancer cell, the immune system, and patient outcome. BMC Anesthesiol. 2018;18(1):77.","DOI":"10.1186\/s12871-018-0543-3"},{"key":"4642_CR12","doi-asserted-by":"crossref","unstructured":"Eugene W, Emilie PB-C, Jack Y, Henry H, Haris S, Frederick DA et al. Effect of perioperative benzodiazepine use on intraoperative awareness and postoperative delirium: a systematic review and meta-analysis of randomised controlled trials and observational studies. Br J Anaesth. 2023;131(2):302\u201313.","DOI":"10.1016\/j.bja.2022.12.001"},{"key":"4642_CR13","doi-asserted-by":"crossref","unstructured":"Jessica S, Emilie B-C, Richard PJD, Kevin W, Graham U. M, Benzodiazepine administration during adult cardiac surgery: a survey of current practice among Canadian anesthesiologists working in academic centres. Can J Anaesth. 2017;65(3):263\u201371.","DOI":"10.1007\/s12630-017-1047-1"},{"key":"4642_CR14","doi-asserted-by":"crossref","unstructured":"Nicholas MH, Daniel JC, Zoe WH, Christine JW, Thorsten MS. Are Patients Taking Benzodiazepines at Increased Risk for Complications Following Primary Total Knee Arthroplasty? J Arthroplasty. 2021;36(5):1611\u20136.","DOI":"10.1016\/j.arth.2020.12.004"},{"key":"4642_CR15","doi-asserted-by":"crossref","unstructured":"Manabu Y, Yoshiyuki H, Yasuhiro M. Association Between the Use of Midazolam During Cardiac Anesthesia and the Incidence of Postoperative Delirium: A Retrospective Cohort Study Using a Nationwide Database. J Cardiothorac Vasc Anesth. 2023;37(12):2546\u201351.","DOI":"10.1053\/j.jvca.2023.08.147"},{"key":"4642_CR16","doi-asserted-by":"crossref","unstructured":"George D, Natalie S, Ludwik F, Jo C, Rima S, Vivek R et al. Dexmedetomidine versus Propofol Sedation Reduces Delirium after Cardiac Surgery: A Randomized Controlled Trial. Anesthesiology. 2015;124(2): 362\u20138.","DOI":"10.1097\/ALN.0000000000000951"},{"key":"4642_CR17","doi-asserted-by":"crossref","unstructured":"Ayinoor VV, Koniparambil PU, Madhur SSB, Suneel PR, Thomas K. Comparison of Propofol-Based Total Intravenous Anesthesia versus Volatile Anesthesia with Sevoflurane for Postoperative Delirium in Adult Coronary Artery Bypass Grafting Surgery: A Prospective Randomized Single-Blinded Study. J Cardiothorac Vasc Anesth. 2024;38(9):1932\u201340.","DOI":"10.1053\/j.jvca.2024.05.027"},{"issue":"2","key":"4642_CR18","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1016\/j.bja.2023.04.024","volume":"131","author":"SJ Cao","year":"2023","unstructured":"Cao SJ, Zhang Y, Zhang YX, Zhao W, Pan LH, Sun XD, et al. Delirium in older patients given propofol or sevoflurane anaesthesia for major cancer surgery: a multicentre randomised trial. Br J Anaesth. 2023;131(2):253\u201365.","journal-title":"Br J Anaesth"},{"issue":"2","key":"4642_CR19","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1097\/ALN.0000000000004438","volume":"138","author":"HJ Shin","year":"2023","unstructured":"Shin HJ, Woo Nam S, Kim H, Yim S, Han SH, Hwang JW, et al. Postoperative Delirium after Dexmedetomidine versus Propofol Sedation in Healthy Older Adults Undergoing Orthopedic Lower Limb Surgery with Spinal Anesthesia: A Randomized Controlled Trial. Anesthesiology. 2023;138(2):164\u201371.","journal-title":"Anesthesiology"},{"issue":"9","key":"4642_CR20","doi-asserted-by":"publisher","first-page":"e825","DOI":"10.1097\/CCM.0000000000003299","volume":"46","author":"JW Devlin","year":"2018","unstructured":"Devlin JW, Skrobik Y, Gelinas C, Needham DM, Slooter AJC, Pandharipande PP, et al. Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation\/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. Crit Care Med. 2018;46(9):e825\u201373.","journal-title":"Crit Care Med"},{"issue":"4","key":"4642_CR21","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1097\/EJA.0000000000000594","volume":"34","author":"C Aldecoa","year":"2017","unstructured":"Aldecoa C, Bettelli G, Bilotta F, Sanders RD, Audisio R, Borozdina A, et al. European Society of Anaesthesiology evidence-based and consensus-based guideline on postoperative delirium. Eur J Anaesthesiol. 2017;34(4):192\u2013214.","journal-title":"Eur J Anaesthesiol"},{"key":"4642_CR22","doi-asserted-by":"crossref","unstructured":"Miriam C, Stella Lukas Y, Rabih C, Daniela F, Laura B, Catia L et al. Pre-Operative, High-IL-6 Blood Level is a Risk Factor of Post-Operative Delirium Onset in Old Patients. Front Endocrinol (Lausanne). 2014;5(0):173 .","DOI":"10.3389\/fendo.2014.00173"},{"issue":"5","key":"4642_CR23","doi-asserted-by":"publisher","first-page":"811","DOI":"10.1053\/j.jvca.2010.05.003","volume":"25","author":"JA Hudetz","year":"2011","unstructured":"Hudetz JA, Iqbal Z, Gandhi SD, Patterson KM, Byrne AJ, Pagel PS. Postoperative delirium and short-term cognitive dysfunction occur more frequently in patients undergoing valve surgery with or without coronary artery bypass graft surgery compared with coronary artery bypass graft surgery alone: results of a pilot study. J Cardiothorac Vasc Anesth. 2011;25(5):811\u20136.","journal-title":"J Cardiothorac Vasc Anesth"},{"issue":"1","key":"4642_CR24","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1186\/s12871-024-02738-9","volume":"24","author":"P Guo","year":"2024","unstructured":"Guo P, Ma Y, Su W, Xie D, Li X, Wang K, et al. Association between baseline serum bicarbonate and the risk of postoperative delirium in patients undergoing cardiac surgery in the ICU: a retrospective study from the MIMIC-IV database. BMC Anesthesiol. 2024;24(1):347.","journal-title":"BMC Anesthesiol"},{"issue":"7","key":"4642_CR25","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.24553","volume":"36","author":"X Su","year":"2022","unstructured":"Su X, Wang J, Lu X. The association between Monocyte-to-Lymphocyte ratio and postoperative delirium in ICU patients in cardiac surgery. J Clin Lab Anal. 2022;36(7):e24553.","journal-title":"J Clin Lab Anal"},{"issue":"2","key":"4642_CR26","doi-asserted-by":"publisher","first-page":"e14343","DOI":"10.1111\/cns.14343","volume":"30","author":"Z Chen","year":"2024","unstructured":"Chen Z, Hao Q, Sun R, Zhang Y, Fu H, Liu S, et al. Predictive value of the geriatric nutrition risk index for postoperative delirium in elderly patients undergoing cardiac surgery. CNS Neurosci Ther. 2024;30(2):e14343.","journal-title":"CNS Neurosci Ther"},{"issue":"5","key":"4642_CR27","doi-asserted-by":"publisher","first-page":"1485","DOI":"10.1177\/07334648211067526","volume":"41","author":"VL Chuen","year":"2022","unstructured":"Chuen VL, Chan ACH, Ma J, Alibhai SMH, Chau V. Assessing the accuracy of International Classification of Diseases (ICD) coding for delirium. J Appl Gerontol. 2022;41(5):1485\u201390.","journal-title":"J Appl Gerontol"},{"key":"4642_CR28","doi-asserted-by":"crossref","unstructured":"Hengrui L, James PD, Jun L. Effects of local anesthetics on cancer cells. Pharmacol Ther. 2020;212(0):107558.","DOI":"10.1016\/j.pharmthera.2020.107558"},{"key":"4642_CR29","doi-asserted-by":"crossref","unstructured":"Hengrui L, James PD, Jun L. Lidocaine Suppresses Viability and Migration of Human Breast Cancer Cells: TRPM7 as a Target for Some Breast Cancer Cell Lines. Cancers (Basel). 2021;13(2):234.","DOI":"10.3390\/cancers13020234"},{"key":"4642_CR30","doi-asserted-by":"crossref","unstructured":"Ru L, Mousumi Beto M, Zhaosheng J, Hengrui L, Kevin L, Qiuyue L et al. The Potential Effect of General Anesthetics in Cancer Surgery: Meta-Analysis of Postoperative Metastasis and Inflammatory Cytokines. Cancers (Basel). 2023;15(10):2759.","DOI":"10.3390\/cancers15102759"},{"key":"4642_CR31","doi-asserted-by":"crossref","unstructured":"C JSLH, B S-A TAL, K-U B et al. Cognitive function after sevoflurane- vs propofol-based anaesthesia for on-pump cardiac surgery: a randomized controlled trial. Br J Anaesth. 2011;106(6):840\u201350.","DOI":"10.1093\/bja\/aer091"},{"key":"4642_CR32","doi-asserted-by":"crossref","unstructured":"C F R, D T A, S N N JS, Z W. J P, The influence of propofol or desflurane on postoperative cognitive dysfunction in patients undergoing coronary artery bypass surgery. Anaesthesia. 2011;66(6):455\u201364.","DOI":"10.1111\/j.1365-2044.2011.06704.x"},{"key":"4642_CR33","doi-asserted-by":"crossref","unstructured":"Y Z, G-J S, Y-X Z, S-J C, S-N Z, H-J L et al. Propofol compared with sevoflurane general anaesthesia is associated with decreased delayed neurocognitive recovery in older adults. Br J Anaesth. 2018;121(3):595\u2013604.","DOI":"10.1016\/j.bja.2018.05.059"},{"key":"4642_CR34","doi-asserted-by":"crossref","unstructured":"Shuang-Jie C, Yue Z, Yu-Xiu Z, Wei Z, Ling-Hui P, Xu-De S et al. Delirium in older patients given propofol or sevoflurane anaesthesia for major cancer surgery: a multicentre randomised trial. Br J Anaesth. 2023;131(2): 253\u201365.","DOI":"10.1016\/j.bja.2023.09.004"},{"issue":"4","key":"4642_CR35","doi-asserted-by":"publisher","first-page":"536","DOI":"10.1016\/j.mehy.2013.06.027","volume":"81","author":"K Brown","year":"2013","unstructured":"Brown K, Mirrakhimov A, Yeddula K, Kwatra M. Propofol and the risk of delirium: exploring the anticholinergic properties of propofol. Med Hypotheses. 2013;81(4):536\u20139.","journal-title":"Med Hypotheses"},{"key":"4642_CR36","doi-asserted-by":"crossref","unstructured":"Ho-Kyung S, Dae Chul J. The effect of propofol on cytotoxicity and apoptosis of lipopolysaccharide-treated mononuclear cells and lymphocytes. Anesth Analg. 2004;98(6):1724\u20138.","DOI":"10.1213\/01.ANE.0000112317.68730.B0"},{"key":"4642_CR37","doi-asserted-by":"crossref","unstructured":"N K, D I S HH, A AK. S, S T, Intraoperative modulation of alveolar macrophage function during isoflurane and propofol anesthesia. Anesthesiology. 1998;89(5):1125\u201332.","DOI":"10.1097\/00000542-199811000-00012"},{"key":"4642_CR38","doi-asserted-by":"crossref","unstructured":"E G D, R S C, R K M TAM. Effect of four i.v. induction agents on T-lymphocyte proliferations to PHA in vitro. Br J Anaesth. 1994;73(3):315\u20137.","DOI":"10.1093\/bja\/73.3.315"},{"key":"4642_CR39","doi-asserted-by":"crossref","unstructured":"J A D, S J B, F J P PZ. G R. Comparison of the effects of four i.v. anaesthetic agents on polymorphonuclear leucocyte function. Br J Anaesth. 1995;74(3):315\u20138.","DOI":"10.1093\/bja\/74.3.315"},{"key":"4642_CR40","doi-asserted-by":"crossref","unstructured":"H F G, A M D, N R W. The effect of midazolam and propofol on interleukin-8 from human polymorphonuclear leukocytes. Anesth Analg. 1998;86(6):1289\u201393.","DOI":"10.1213\/00000539-199806000-00030"},{"key":"4642_CR41","doi-asserted-by":"crossref","unstructured":"Silverio S, Anna N, Simona S, Dorela H, Annamaria M, Maria L et al. Differential modulatory effects of Propofol and Sevoflurane anesthesia on blood monocyte HLA-DR and CD163 expression during and after cardiac surgery with cardiopulmonary bypass: a preliminary randomized flow cytometry study. Perfusion. 2019;35(1):48\u201356.","DOI":"10.1177\/0267659119848295"},{"key":"4642_CR42","doi-asserted-by":"crossref","unstructured":"Minna K, Annalotta S, Mikael M, Jaakko L, Kaike K, Riikka T et al. The influence of dexmedetomidine and propofol on circulating cytokine levels in healthy subjects. BMC Anesthesiol. 2019;19(1):222.","DOI":"10.1186\/s12871-019-0895-3"},{"key":"4642_CR43","doi-asserted-by":"crossref","unstructured":"M T, T Y, M O-T SA. Effects of intravenous anesthetics on interleukin (IL)-6 and IL-10 production by lipopolysaccharide-stimulated mononuclear cells from healthy volunteers. Acta Anaesthesiol Scand. 2002;46(2):176\u20139.","DOI":"10.1034\/j.1399-6576.2002.460209.x"},{"key":"4642_CR44","unstructured":"F G, U T. G C, M G. [The angina pectoris patient in dental practice]. Minerva Stomatol. 1986;35(1-2 ):23\u20136."},{"key":"4642_CR45","doi-asserted-by":"crossref","unstructured":"C RG. DO, S B, R M, P M, G F, Study protocol: understanding the pathophysiologic mechanisms underlying delirium in older people undergoing hip fracture surgery. BMC Geriatr. 2021;21(1):633.","DOI":"10.1186\/s12877-021-02584-1"},{"key":"4642_CR46","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2021.106844","volume":"208","author":"H Wang","year":"2021","unstructured":"Wang H, Liu Y, Zhao J, Guo X, Hu M, Chen Y. Possible inflammatory mechanisms and predictors of Parkinson\u2019s disease patients with fatigue (brief review). Clin Neurol Neurosurg. 2021;208:106844.","journal-title":"Clin Neurol Neurosurg"},{"issue":"4","key":"4642_CR47","doi-asserted-by":"publisher","first-page":"359","DOI":"10.5606\/ArchRheumatol.2016.6045","volume":"31","author":"A Yetisgin","year":"2016","unstructured":"Yetisgin A, Tutoglu A, Cinakli A, Kul M, Boyaci A. Platelet and Erythrocyte Indexes in Complex Regional Pain Syndrome Type I. Arch Rheumatol. 2016;31(4):359\u201362.","journal-title":"Arch Rheumatol"},{"key":"4642_CR48","doi-asserted-by":"crossref","unstructured":"B C A GK, F A K MD. F M D. Red cell distribution width levels in Parkinson\u2019s disease patients. Acta Neurol Belg. 2019;120(5):1147\u201350.","DOI":"10.1007\/s13760-019-01197-1"},{"issue":"6","key":"4642_CR49","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1016\/j.jaci.2008.09.006","volume":"122","author":"L Moens","year":"2008","unstructured":"Moens L, Wuyts G, Boon L, den Hartog MT, Ceuppens JL, Bossuyt X. The human polysaccharide- and protein-specific immune response to Streptococcus pneumoniae is dependent on CD4(+) T lymphocytes, CD14(+) monocytes, and the CD40-CD40 ligand interaction. J Allergy Clin Immunol. 2008;122(6):1231\u20133.","journal-title":"J Allergy Clin Immunol"},{"key":"4642_CR50","doi-asserted-by":"crossref","unstructured":"Daniel M, Marc A, Judith S, Rawa A, Matthias K, Florian L et al. Monocyte Metabolism and Function in Patients Undergoing Cardiac Surgery. Front Cardiovasc Med. 2022;9(0):853967.","DOI":"10.3389\/fcvm.2022.853967"},{"key":"4642_CR51","doi-asserted-by":"crossref","unstructured":"A P SW. Y. Cytokines in myocardial injury: impact on cardiac surgical approach. Eur J Cardiothorac Surg. 1999;16(Supplement_10):S107\u201311.","DOI":"10.1016\/S1010-7940(99)00200-6"},{"key":"4642_CR52","doi-asserted-by":"crossref","unstructured":"J L L SW. J L V. Cytokine responses to cardiopulmonary bypass: lessons learned from cardiac transplantation. Ann Thorac Surg. 1997;63(1):269\u201376.","DOI":"10.1016\/S0003-4975(96)00931-9"},{"key":"4642_CR53","doi-asserted-by":"crossref","unstructured":"Minxin W, Pekka K, Jari L, Erkki P, Seppo K, Seppo L et al. Cytokine Responses in Low-Risk Coronary Artery Bypass Surgery. Int J Angiol. 2001;10(1):27\u201330.","DOI":"10.1055\/s-0031-1276274"},{"key":"4642_CR54","doi-asserted-by":"crossref","unstructured":"Xunling S, Jie W, Xing L. The association between Monocyte-to-Lymphocyte ratio and postoperative delirium in ICU patients in cardiac surgery. J Clin Lab Anal. 2022;36(7):e24553.","DOI":"10.1002\/jcla.24553"},{"key":"4642_CR55","doi-asserted-by":"crossref","unstructured":"Jingyi T, Shengke Z, Lai J, Jie L, Jiayu X, Chenglu J et al. Causal relationship between immune cells and hepatocellular carcinoma: a Mendelian randomisation study. J Cancer. 2024;15(13):4219-31.","DOI":"10.7150\/jca.96744"},{"issue":"4","key":"4642_CR56","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1023\/A:1022316815196","volume":"22","author":"G Fingerle-Rowson","year":"1998","unstructured":"Fingerle-Rowson G, Auers J, Kreuzer E, Fraunberger P, Blumenstein M, Ziegler-Heitbrock LH. Expansion of CD14\u2009+\u2009CD16+ monocytes in critically ill cardiac surgery patients. Inflammation. 1998;22(4):367\u201379.","journal-title":"Inflammation"},{"key":"4642_CR57","doi-asserted-by":"crossref","unstructured":"Jana CM, Tobias UJ, Jessica P, Anke L, Lukas B, Christian S et al. Elevated circulating CD14(++)CD16(+) intermediate monocytes are independently associated with extracardiac complications after cardiac surgery. Sci Rep. 2020;10(1):947.","DOI":"10.1038\/s41598-020-57700-9"},{"key":"4642_CR58","doi-asserted-by":"crossref","unstructured":"Andreas P, Markus C, Sijal N, Kaj B, Henrik Z, Niklas M. Effects of surgery and propofol-remifentanil total intravenous anesthesia on cerebrospinal fluid biomarkers of inflammation, Alzheimer\u2019s disease, and neuronal injury in humans: a cohort study. J Neuroinflammation. 2017;14(1):193.","DOI":"10.1186\/s12974-017-0950-2"},{"key":"4642_CR59","doi-asserted-by":"crossref","unstructured":"Alasdair MJM, Karen JF, Thomas M, Sophia EJA, dR, Colm C. Unravelling the pathophysiology of delirium: a focus on the role of aberrant stress responses. J Psychosom Res. 2008;65(3):229\u201338.","DOI":"10.1016\/j.jpsychores.2008.05.019"},{"key":"4642_CR60","doi-asserted-by":"crossref","unstructured":"Wilson JE, Mart MF, Cunningham C, Shehabi Y, Girard TD, MacLullich AMJ et al. Delirium. Nat Rev Dis Primers. 2020;6(1):90.","DOI":"10.1038\/s41572-020-00223-4"},{"key":"4642_CR61","doi-asserted-by":"crossref","unstructured":"Alasdair MJM, Atul A, Daniel HJD, Thomas J, Amanda JB, Roanna JH et al. New horizons in the pathogenesis, assessment and management of delirium. Age Ageing. 2013;42(6):667\u201374.","DOI":"10.1093\/ageing\/aft148"},{"issue":"1","key":"4642_CR62","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1038\/s41398-022-02297-y","volume":"13","author":"B Guo","year":"2023","unstructured":"Guo B, Zhang M, Hao W, Wang Y, Zhang T, Liu C. Neuroinflammation mechanisms of neuromodulation therapies for anxiety and depression. Transl Psychiatry. 2023;13(1):5.","journal-title":"Transl Psychiatry"},{"issue":"12","key":"4642_CR63","doi-asserted-by":"publisher","first-page":"1373","DOI":"10.1016\/S0895-4356(96)00236-3","volume":"49","author":"P Peduzzi","year":"1996","unstructured":"Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol. 1996;49(12):1373\u20139.","journal-title":"J Clin Epidemiol"}],"container-title":["Journal of Cardiothoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13019-026-04642-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-026-04642-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-026-04642-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T12:52:59Z","timestamp":1791982379000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13019-026-04642-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,20]]},"references-count":63,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4642"],"URL":"https:\/\/doi.org\/10.1186\/s13019-026-04642-4","relation":{},"ISSN":["1749-8090"],"issn-type":[{"value":"1749-8090","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,20]]},"assertion":[{"value":"9 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"In accordance with the Declaration of Helsinki, the Ethics Committee of The Affiliated Lihuili Hospital of Ningbo University deemed that this research is based on open-source data, so the need for ethics approval was waived.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"789"}}