摘要
Abstract
Objective To identify the incidence and risk factors of postoperative delirium in elderly patients in critical condition after non-cardiac surgery. Methods One hundred and twenty-five elderly patients who were admitted to the surgical intensive care unit (SICU)after non-cardiac surgery were involved in the present study. Baseline and the perioperative variables of patients were collected.Postoperative delirium was diagnosed using the Confusion Assessment Method for Intensive Care Unit (CAM-ICU). Delirium assessment was performed once daily during the first five days after surgery. Results Postoperative evaluations of delirium were completed in 124 patients. Postoperative delirium occurred in 42 patients (33.87％), among them delirium occurred within the first 2 postoperative days in 92.86％(39/42) (4.76％ in the operative day, 50.00％ in the first postoperative day, and 38.10％ in the second postoperative day,respectively). When compared with the non-delirious patients, the delirious patients had longer duration of ICU stay [39.75 (21.00-65.63)h vs 19.63 (17.77-22.31)h., P=0.000], higher incidence of postoperative complications [(38. 1％(16/42) vs 13.4％ (11/82), P =0.000], and higher mortality [11.9％(5/42) vs 1.2％(1/82), P=0.000]. Multivariate logistic regression analysis demonstrated that the following risk factors predicted the occurrence of postoperative delirium: preoperative history of cerebral accident ( OR=3.051, 95％CI 1.032-8.370), high APACHE Ⅱ score at admission to the SICU ( OR=1.664, 95％ CI 1.268-2.184), and high pain score at 24 hours after operation (OR=1.043,95％ CI 1.021 - 1.086). Conclusions Delirium is a common complication after surgery. The prognosis is significantly worse in the delirious patients than in the non-delirious patients. Risk factors of postoperative delirium include history of preoperative cerebral accident. high APACHE Ⅱ score at admission to the SICU, and high pain score at 24 hours after operation.关键词
外科重症/老年人/术后谵妄/预后/危险因素Key words
surgical critical/ aged / postoperative delirium/ prognosis / risk factor分类
医药卫生
