谵妄
医学
风险因素
萧条(经济学)
器质性精神障碍
血压
心房颤动
逻辑回归
外科
内科学
冠状动脉搭桥手术
麻醉
心脏病学
动脉
优势比
入射(几何)
冠状动脉疾病
围手术期
旁路移植
重症监护医学
经济
宏观经济学
作者
Franklin Santana Santos,Irineu Tadeu Velasco,Renério Fráguas
出处
期刊:International Psychogeriatrics
日期:2004-06-01
卷期号:16 (2): 175-193
被引量:117
标识
DOI:10.1017/s1041610204000365
摘要
Objective: To investigate the risk factors for delirium in the elderly during the post-operative period of coronary artery bypass graft surgery (CABG). Methods: A total of 220 inpatients submitted to CABG were evaluated prior to and after surgery. In order to investigate the possible risk factors, data were collected from pre-intra- and post-operative periods. Instruments: The patients were assessed using the Mini-mental State Examination and to the Geriatric Depression Scale. The diagnosis of delirium was determined according to DSM-IV criteria. Results: Delirium was detected in 74 (33.6%) patients. Increasing age, blood urea level, cardio-thoracic index, hypertension, smoking habits, blood replacement during bypass, atrial fibrillation (AF), pneumonia and blood balance in the post-operative period were the risk factors for delirium selected by the logistic regression analysis. No specific factor associated with the CABG (perfusion pressure, number of grafts) was correlated with an increased risk for delirium post-operatively. The length of stay was twice as long in the delirious group ( p <0,001). Conclusions: Delirium in the elderly after CABG is a multifactorial disorder. Nine factors taken together can identify patients at great risk for delirium. No specific factor associated with bypass procedure could be identified as a risk factor for delirium. The control of the risk factors should bring a decrease in delirium morbidity and mortality.
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