Research on the prediction of comprehensive geriatric assessment on postoperative delirium in elderly patients in cardiac surgery department
10.3760/cma.j.issn.1674-2907.2018.07.016
- VernacularTitle:老年综合评估在心外科老年患者术后谵妄预测中的应用
- Author:
Chaohong CHEN
1
;
Xueping LI
;
Yanli CHEN
;
Xiaohua CHEN
;
Ailing LIN
Author Information
1. 温州医科大学附属第一医院心胸外科
- Keywords:
Aged;
Cardiac surgery;
Delirium;
Comprehensive geriatric assessment
- From:
Chinese Journal of Modern Nursing
2018;24(7):809-813
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the prediction of comprehensive geriatric assessment (CGA) on postoperative delirium (POD) in elderly patients after cardiac surgery. Methods A total of 276 patients from cardiac surgery department were selected from January 2015 to December 2016 by convenience sampling method. The general clinical data of the subjects were recorded and the CGA was conducted. POD assessment was performed on the 1st to the 7th day postoperatively using Confusion Assessment Method-Intensive Care Unit (CAM-ICU) or Confusion Assessment Method (CAM). Single factor analysis and multiple Logistic regression analysis were applied to analyze the factors influencing the incidence of POD after cardiac surgery in elderly patients. Results A total of 98 cases showed POD, with the incidence of 35.5%. Compared with the non-POD patients, the patients with POD were older; the proportion of history of cerebrovascular disease, atrial fibrillation, cardiopulmonary bypass, intraoperative blood transfusion was higher; the mechanical ventilation duration was longer; the score of Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ), the postoperative pain score, the level of serum creatinine and C-reactive protein (CRP) were higher; the proportion of patients with CGA score over 15 was significantly higher, and all the differences were statistically significant (P< 0.05). Logistic multivariate regression analysis showed that the history of cerebrovascular disease, cardiopulmonary bypass, APACHE Ⅱ score, postoperative pain score and CGA score over 15 were independent risk factors for POD. Conclusions CGA can predict patients with cardiac surgery with high risk of postoperative delirium, which has a certain significance for the prevention and treatment of postoperative delirium and improve the prognosis.
