Analysis of risk factors for postoperative delirium after extracorporeal circulation in cardiac surgery
10.3760/cma.j.cn112434-20230408-00078
- VernacularTitle:心脏外科体外循环术后谵妄的危险因素分析
- Author:
Fengbo PEI
1
;
Yao YAO
;
Chen SHI
;
Hui WU
;
Zujun CHEN
Author Information
1. 北京大学人民医院心外科，北京 100044
- Keywords:
Cardiac surgery;
Delirium;
Risk factors
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2023;39(12):750-753
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the risk factors for postoperative delirium in cardiac surgery through an observational cohort study.Methods:Data of postoperative cardiac surgery patients (1 562 cases)who underwent median open-heart extracorporeal circulation between January 2020 and April 2021 at Fuwai Hospital were prospectively included, and patients were divided into delirium group(503 cases, 32.2%) and non-delirium group(1 059 cases, 67.8%) according to whether delirium occurred after surgery, and clinical indicators of the two groups were compared preoperatively, intraoperatively and postoperatively to determine the risk factors for postoperative delirium.Results:The first 48 h after surgery was the high incidence of delirium, accounting for 87.2% of the total incidence of delirium. The incidence of postoperative delirium varied widely among patients with different types of cardiac surgery. The percentage of unemployment and joblessness was higher in delirium group (7.3% vs. 4.8%, P<0.05), and the percentage of hypertension and carotid stenosis were higher than those in non-delirium group( P<0.05). Statistical differences existed between the type of surgery, intraoperative extracorporeal circulation time and block time, and intraoperative hypotensive events (MAP<40 mmHg, 1 mmHg=0.133 kPa), P<0.05. The first postoperative blood glucose was higher in delirium group , and the first blood gas partial pressure of oxygen and the first postoperative ultrasound left ventricular ejection fraction were lower than those in non-delirium group( P<0.05). There was no statistical difference in the duration of postoperative mechanical ventilation between the two groups( P>0.05), but the mean ICU stay was higher in delirium group ( P<0.05). The in-hospital mortality rate , the incidence of postoperative respiratory complications, and the mean hospitalization cost were also higher in delirium group than those in non-delirium group ( P<0.05). Multifactorial logistic regression analysis showed that carotid stenosis, preoperative hypertension, intraoperative block time >120 min and first postoperative blood glucose were independent risk factors for postoperative cardiac delirium. Conclusion:Carotid stenosis, preoperative hypertension, intraoperative block time >120 min and first postoperative blood glucose were independent risk factors for postoperative cardiac delirium.
