PDF(Pubmed)
Abstract：
BACKGROUND: Postoperative delirium (POD), an acute and variable disturbance in cognitive function, is an intricate and elusive phenomenon that occurs after cardiac surgery. Despite progress in surgical techniques and perioperative management, POD remains a formidable challenge, imposing a significant burden on patients, caregivers, and healthcare systems.
METHODS: This prospective observational study involved 307 patients who underwent cardiac surgery. Data on the occurrence of delirium, clinical parameters, and postoperative characteristics were collected. A multivariate analysis was performed to assess the relationship between POH and POD.
RESULTS: Sixty-one patients (21%) developed delirium, with an average onset of approximately 5 days postoperatively and a duration of approximately 6 days. On multivariate analysis, POH was significantly associated with POD, and the adjusted odds ratios indicated that patients with POH were more likely to develop delirium (OR, 5.61; p = 0.006). Advanced age (OR, 1.11; p = 0.002), emergency surgery (OR, 8.31; p = 0.001), and on-pump coronary artery bypass grafting were identified as risk factors of POD. Patients who developed delirium were typically older, more likely to be male, and had higher morbidity rates than those who did not.
CONCLUSIONS: POH is significantly associated with delirium in critically ill patients after cardiac surgery. Surgical complexity and advanced age contribute to the risk of developing POD and poor postoperative outcomes.
METHODS: This prospective observational study involved 307 patients who underwent cardiac surgery. Data on the occurrence of delirium, clinical parameters, and postoperative characteristics were collected. A multivariate analysis was performed to assess the relationship between POH and POD.
RESULTS: Sixty-one patients (21%) developed delirium, with an average onset of approximately 5 days postoperatively and a duration of approximately 6 days. On multivariate analysis, POH was significantly associated with POD, and the adjusted odds ratios indicated that patients with POH were more likely to develop delirium (OR, 5.61; p = 0.006). Advanced age (OR, 1.11; p = 0.002), emergency surgery (OR, 8.31; p = 0.001), and on-pump coronary artery bypass grafting were identified as risk factors of POD. Patients who developed delirium were typically older, more likely to be male, and had higher morbidity rates than those who did not.
CONCLUSIONS: POH is significantly associated with delirium in critically ill patients after cardiac surgery. Surgical complexity and advanced age contribute to the risk of developing POD and poor postoperative outcomes.
摘要：
背景：术后谵妄（POD），认知功能的急性和可变障碍，是心脏手术后发生的复杂而难以捉摸的现象。尽管在手术技术和围手术期管理方面取得了进展，POD仍然是一个巨大的挑战，给患者带来了巨大的负担，看护者,和医疗保健系统。
方法：这项前瞻性观察性研究包括307例心脏手术患者。关于谵妄发生的数据，临床参数,并收集术后特点。进行多变量分析以评估POH和POD之间的关系。
结果：61例患者（21%）出现谵妄，术后平均发病约5天，持续时间约6天。在多变量分析中，POH与POD显著相关,调整后的比值比表明，POH患者更容易发生谵妄(OR，5.61；p=0.006）。高龄（或，1.11；p=0.002），急诊手术（或，8.31；p=0.001），和体外循环冠状动脉旁路移植术被确定为POD的危险因素。发生谵妄的患者通常年龄较大，更有可能是男性，发病率高于那些没有的人。
结论：POH与心脏手术后危重患者谵妄显著相关。手术复杂性和高龄导致发生POD的风险和术后不良结局。
方法：这项前瞻性观察性研究包括307例心脏手术患者。关于谵妄发生的数据，临床参数,并收集术后特点。进行多变量分析以评估POH和POD之间的关系。
结果：61例患者（21%）出现谵妄，术后平均发病约5天，持续时间约6天。在多变量分析中，POH与POD显著相关,调整后的比值比表明，POH患者更容易发生谵妄(OR，5.61；p=0.006）。高龄（或，1.11；p=0.002），急诊手术（或，8.31；p=0.001），和体外循环冠状动脉旁路移植术被确定为POD的危险因素。发生谵妄的患者通常年龄较大，更有可能是男性，发病率高于那些没有的人。
结论：POH与心脏手术后危重患者谵妄显著相关。手术复杂性和高龄导致发生POD的风险和术后不良结局。
