Risk factors for postoperative delirium in patients after Stanford A aortic dissection surgery: a prospective cohort study / 中华胸心血管外科杂志
Chinese Journal of Thoracic and Cardiovascular Surgery
;
(12): 607-611, 2016.
Artículo
en Chino
| WPRIM
| ID: wpr-506378
ABSTRACT
Objective This study aims to analyze the independent risk factors associated with postoperative delirium of patients undergoing Stanford A aortic dissection surgery.Methods Clinical data of the patients who underwent Stanford A aortic dissection surgery from December 2014 to October 2015 were collected.All patients received surgery under deep hypothermic circulatory arrest(DHCA) and the nasal temperature goal was below 23℃.After surgery,patients were transferred to the cardiovascular ICU,where they received standard postoperative care.The delirium was diagnosed according to the criteria of the confusion assessment method for the intensive care unit(CAM-ICU).The possible risk factors of pre-operation,during operation or post-operation were analyzed via univariate analysis and multivariate logistic regression to determine the independent risk factorsof postoperative delirium.Results 148 patients underwent Stanford A aortic dissection surgery which the incidence of postoperative delirium was 31.1% (46/148).Univariate analysis showed the associated risk factors were age,hypertension,cognitive impairment,emergency operation,operation time,aorta clamping time,DHCA time,fluctuation of blood pressure during operation,blood transfusion,quality of sleep,length of ICU stay and electrolyte disturbance(P < 0.05).Multivariate logistic regression analysis revealed that hypertension,cognitive impairment,fluctuation of mean arterial blood pressure(MAP) > 30 mmHg (1 mmHg =0.133 kPa),DHCA time > 40 min,postoperative poor quality of sleep and electrolyte disturbance were independently associated with postoperative delirium after Stanford A aortic dissection surgery(P < 0.05).Conclusion Delirium is a frequent complication.Factors independently associated with delirium are hypertension,cognitive impairment,DHCA time,postoperative poor quality of sleep and electrolyte disturbance.Prevent,assess and manage delirium should be paid more attention and reinforced.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Tipo de estudio:
Estudio de etiología
/
Estudio observacional
/
Factores de riesgo
Idioma:
Chino
Revista:
Chinese Journal of Thoracic and Cardiovascular Surgery
Año:
2016
Tipo del documento:
Artículo
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