Preoperative Risk Factors and Early Outcomes of Delirium in Valvular Open-Heart Surgery

医学 谵妄 优势比 重症监护室 入射(几何) 冲程(发动机) 外科 心脏外科 置信区间 瓣膜性心脏病 麻醉
作者
Nikolai Hulde,Armin Zittermann,Katharina Tigges-Limmer,Andreas Koster,Nicole Weinrautner,Jan Gummert,Vera von Dossow
出处
期刊:Thoracic and Cardiovascular Surgeon [Georg Thieme Verlag]
标识
DOI:10.1055/s-0041-1740984
摘要

Abstract Background Compared with coronary artery bypass grafting surgery, data regarding postoperative delirium are scant in valvular open-heart surgery. Therefore, the goal of this retrospective study was to investigate the incidence, preoperative risk factors, and early outcomes of delirium in a large group of patients undergoing valvular open-heart surgery. Methods In 13,229 patients with isolated valvular or combined valvular and bypass surgery, the incidence of postoperative delirium was assessed until discharge. Independent risk factors of delirium were evaluated by multivariable logistic regression analysis. Moreover, we assessed the multivariable-adjusted risk of prolonged intensive care unit (ICU) stay (>48 hours) and in-hospital mortality in patients with delirium. Results Overall, the incidence of postoperative delirium was 8.4%. The incidence in patients experiencing a postoperative stroke or seizure was 23.1 and 29.7%, respectively. Twelve preoperative risk factors, mostly nonmodifiable, were independently associated with the risk of delirium, including advanced age, renal impairment, stroke, the need for emergency surgery, and severe preoperative anemia (hemoglobin < 9 g/dL). Postoperative delirium was associated with an adjusted odds ratio (OR) of prolonged ICU stay of 9.48 (95% confidence interval [CI]: 7.96–11.30). Adjusted in-hospital mortality was, however, significantly lower in patients with delirium versus patients without delirium (OR, 0.56; 95% CI: 0.38–0.83). Conclusion In valvular open-heart surgery, postoperative delirium is a frequent neurological complication that is associated with other postoperative neurological complications and several, mostly nonmodifiable, preoperative risk factors. Although postoperative delirium was associated with a significantly increased risk of prolonged ICU stay, this did not translate into an increased short-term mortality.

科研通智能强力驱动
Strongly Powered by AbleSci AI
科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
万能图书馆应助wcy采纳,获得10
刚刚
gege发布了新的文献求助10
刚刚
66完成签到,获得积分10
1秒前
Albert完成签到,获得积分10
1秒前
伶俐悟空发布了新的文献求助20
1秒前
1秒前
星辰大海应助只与你采纳,获得10
2秒前
2秒前
3秒前
天天向上发布了新的文献求助10
3秒前
花间盏完成签到 ,获得积分10
3秒前
jianguo完成签到,获得积分10
4秒前
久念完成签到,获得积分10
4秒前
Lgh完成签到,获得积分10
5秒前
5秒前
希望天下0贩的0应助haorui采纳,获得10
6秒前
日落发布了新的文献求助10
6秒前
6秒前
6秒前
6秒前
chan完成签到,获得积分10
7秒前
tuntunliu完成签到,获得积分10
7秒前
小白发布了新的文献求助10
7秒前
热心诺言发布了新的文献求助10
7秒前
8秒前
8秒前
8秒前
吴媛媛完成签到,获得积分10
8秒前
8秒前
8秒前
9秒前
liuguohua126发布了新的文献求助10
10秒前
隐形曼青应助materials_采纳,获得10
10秒前
TaoJ发布了新的文献求助10
11秒前
我是老大应助lq采纳,获得10
11秒前
gege完成签到,获得积分10
11秒前
12秒前
情怀应助优雅的WAN采纳,获得10
12秒前
wcy发布了新的文献求助10
12秒前
英姑应助DreamLly采纳,获得10
12秒前
高分求助中
Les Mantodea de Guyane Insecta, Polyneoptera 2500
Technologies supporting mass customization of apparel: A pilot project 450
A Field Guide to the Amphibians and Reptiles of Madagascar - Frank Glaw and Miguel Vences - 3rd Edition 400
Brain and Heart The Triumphs and Struggles of a Pediatric Neurosurgeon 400
Cybersecurity Blueprint – Transitioning to Tech 400
Mixing the elements of mass customisation 400
Периодизация спортивной тренировки. Общая теория и её практическое применение 310
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 物理 生物化学 纳米技术 计算机科学 化学工程 内科学 复合材料 物理化学 电极 遗传学 量子力学 基因 冶金 催化作用
热门帖子
关注 科研通微信公众号,转发送积分 3785157
求助须知:如何正确求助?哪些是违规求助? 3330567
关于积分的说明 10247380
捐赠科研通 3046041
什么是DOI,文献DOI怎么找? 1671820
邀请新用户注册赠送积分活动 800855
科研通“疑难数据库(出版商)”最低求助积分说明 759730