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18 May 2019 : Clinical Research  

Risk Factors for Postoperative Delirium in Type A Aortic Dissection Patients: A Retrospective Study

Qiankun Shi1ACEF, Xinwei Mu1BF, Cui Zhang1AD, Shu Wang1CE, Liang Hong1BE, Xin Chen2ABDG*

DOI: 10.12659/MSM.913774

Med Sci Monit 2019; 25:3692-3699

Abstract

BACKGROUND: Postoperative delirium (POD) is a common complication in cardiac surgery among adult patients. This retrospective study was designed to identify the risk factors associated with POD of type A aortic dissection patients.

MATERIAL AND METHODS: Clinical data of 148 patients with type A aortic dissection in the Department of Critical Care Medicine was retrospectively analyzed. All these patients underwent Sun’s procedure with anesthetic treatment. The confusion assessment method for intensive care unit (CAM-ICU) was adapted to evaluate the delirium status of these patients. They were divided into 2 groups: the delirium group and the control group. Univariate analysis and multivariate logistic regression were performed in succession to determine the independent risk factors for POD.

RESULTS: The average age of these patients was 54.41±11.676 years old. Among the 148 patients, POD was detected in 68 patients, with an incidence of 45.95%. According to univariate analysis, age, irritability, alcohol use, extracorporeal circulation duration (cardiopulmonary bypass, CPB time), antegrade selective cerebral perfusion (ASCP) time, lowest partial pressure of oxygen (lowest PO2), mechanical ventilation time, blood loss, low PO₂ and oxygenation index, hemoglobin (Hb), Intensive Care Unit (ICU) stay, and dihydroxyphenylalanine (DEX) were associated with higher odds of POD among type A aortic dissection patients. According to further analysis of multivariate logistic regression, ASCP time and irritability were confirmed as the independent factors for POD of type A aortic dissection patients.

CONCLUSIONS: We determined 2 independent risk factors for POD: ASCP time and irritability. Identifying and adjusting these risk factors are very important in reducing the incidence of POD among type A aortic dissection patients.

Keywords: Aortic Diseases, Delirium, Risk Factors, Aged, Aneurysm, Dissecting, Cardiac Surgical Procedures, China, Incidence, Logistic Models, Middle Aged, Perfusion, Postoperative Complications, Retrospective Studies, Risk Assessment, Time Factors

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750