心脏手术患者术后谵妄的风险因素。

IF 2.6 4区 综合性期刊 Q2 MULTIDISCIPLINARY SCIENCES Science Progress Pub Date : 2024-07-01 DOI:10.1177/00368504241266362
Min-Song Kim, Sang-Hee Kim
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引用次数: 0

摘要

目的:由于多种因素,心脏手术后入住重症监护室(ICU)的患者极有可能出现谵妄。本研究旨在确定心脏手术成年患者术后谵妄的发生率及其风险因素,如受试者特征、疾病和治疗相关特征以及护理相关特征。研究方法研究对象为在 D 市 Y 大学医院接受心脏手术的成年患者,共有 195 名患者符合纳入标准。结果研究结果显示,195 名成人心脏手术患者中有 67 人出现术后谵妄,其中 53.7% 发生在重症监护室,46.3% 发生在普通病房。术后谵妄的风险因素包括术后炎症症状(比值比 [OR] = 10.18,P = 0.002)、术后持续应用肾脏替代疗法(OR = 9.05,P = 0.006)、术后睡眠障碍(OR = 8.98,P = 0.006)、在重症监护室的住院时间(OR = 3.83,P = 0.031)、中风病史(OR = 3.71,P = 0.033)、术后导管留置次数(OR = 1.53,P = 0.065)、急性生理学和慢性健康评价Ⅱ评分(OR = 1.12,P = 0.006)和手术时间(OR = 1.01,P = 0.042)。结论本研究证实,心脏手术后,患者在入住重症监护室期间和转入普通病房后会出现术后谵妄。考虑到心脏手术后 ICU 相关因素会影响普通病房谵妄的发生率,因此有必要在患者转入普通病房后持续监测 ICU 相关因素。
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Risk factors for postoperative delirium in patients with cardiac surgery.

Purpose: Patients admitted to the intensive care unit (ICU) after cardiac surgery are at high risk of delirium due to a variety of factors. This study aimed to identify the incidence of postoperative delirium in adult patients with cardiac surgery and its risk factors, such as characteristics of subjects, disease and treatment-related, as well as nursing-related characteristics. Methods: The study was performed on adult patients who underwent cardiac surgery at Y University Hospital in D city; a total of 195 patients met the inclusion criteria. Results: The results of this study determined that 67 of 195 adult cardiac surgery patients had postoperative delirium, 53.7% of which occurred in the ICU and 46.3% in the general ward. Risk factors of postoperative delirium were postoperative symptoms of inflammation (odds ratio [OR] = 10.18, p = 0.002), continuous renal replacement therapy application after surgery (OR = 9.05, p = 0.006), postoperative sleep disorder (OR = 8.98, p < 0.001), age (OR = 6.23, p = 0.006), length of stay in the ICU (OR = 3.83, p = 0.031), history of stroke (OR = 3.71, p = 0.033), the number of postoperative catheter retention (OR = 1.53, p = 0.065), Acute Physiology and Chronic Health Evaluation Ⅱ score (OR = 1.12, p = 0.006), and time of operation (OR = 1.01, p = 0.042). Conclusion: This study confirmed that after cardiac surgery, postoperative delirium occurred in patients during their ICU stay and after their transfer to a general ward. Considering that after cardiac surgery ICU-related factors affect the incidence of delirium in the general ward, there is a need for continuous monitoring of ICU-related factors after the patient gets transferred to a general ward.

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来源期刊
Science Progress
Science Progress Multidisciplinary-Multidisciplinary
CiteScore
3.80
自引率
0.00%
发文量
119
期刊介绍: Science Progress has for over 100 years been a highly regarded review publication in science, technology and medicine. Its objective is to excite the readers'' interest in areas with which they may not be fully familiar but which could facilitate their interest, or even activity, in a cognate field.
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