Analysis of the related risk factors of postoperative delirium in patients with Stanford type A aortic dissection
10.11958/20180420
- VernacularTitle:Stanford A型主动脉夹层患者术后谵妄的相关危险因素分析
- Author:
Yao-Bang BAI
1
;
Pei-Jun LI
;
Zhen-Hua WU
;
Yun-Peng BAI
Author Information
1. 天津市胸科医院心外科 300222
- Keywords:
delirium;
risk factors;
multivariate analysis;
aortic dissection;
Stanford type A
- From:
Tianjin Medical Journal
2018;46(5):471-474
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the related risk factors of postoperative delirium(POD)in patients with Stanford type A aortic dissection, and to guide clinical practices. Methods The clinical data of 118 cases [81 males and 37 females, average age (55.0 ± 10.3) years] with Stanford type A aortic dissection in Tianjin Chest Hospital from January 2016 to December 2017 were analysed in this study. According to whether developed delirium after surgery, the patients were divided into POD group(n=56)and Non-POD group(n=62).The preoperative,perioperative,and postoperative clinical data were collected.The univariate and multivariate Logistic regression analysis was used to investigate the risk factors of POD in patients with the Stanford type A aortic dissection. Results Single factor analysis showed that the proportions of drinking and cerebrovascular history significantly increased,the proportions of early electrolyte disorder and hypoxemia significantly increased, the levels of granulocytes / lymphocytes, circulatory time and blood volume during operation increased significantly, and the duration from onset to operation was decreased, but fibrinogen level decreased significantly in POD group than those of Non-POD group (P < 0.05). Multivariate Logistic analysis indicated that the more intraoperative consumption of blood (OR=1.733, 95% CI:1.409-2.129) and early postoperative electrolyte disorder (OR=10.500, 95% CI:2.930-37.622)were independent risk factors of POD,while the higher level of preoperative fibrinogen(OR=0.157,95% CI:0.050-0.635) and longer time from onset to surgery (OR=0.871, 95% CI:0.808-0.943) were protective factors of POD in patients with Stanford type A aortic dissection.Conclusion The early identification of risk factors of POD,and the active intervention of POD have a positive significance to reduce the occurrence of POD.
