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Observational Study
. 2020 Jul 14;15(1):171.
doi: 10.1186/s13019-020-01217-9.

Risk factors for postoperative delirium in patients with triple-branched stent graft implantation

Yanjuan Lin  1 , Qiong Chen  2 , Haoruo Zhang  3 , Liang-Wan Chen  4 , Yanchun Peng  5 , Xizhen Huang  5 , Yiping Chen  2 , Sailan Li  5 , Lingyu Lin  2
Affiliations
Observational Study

Risk factors for postoperative delirium in patients with triple-branched stent graft implantation

Yanjuan Lin et al. J Cardiothorac Surg. .

Abstract

Background: Neurological complications is a common complication following novel triple-branched stent graft implantation in patients with Stanford type A aortic dissection (AAD). But the incidence and risk factors of postoperative delirium (POD) are not completely clear. The aim of this study was to investigate the incidence and risk factors of POD after novel triple-branched stent graft implantation.

Methods: An observational study of AAD patients who underwent novel triple-branched stent graft implantation between January 2017 and July 2019 were followed up after surgery. Patients' delirium was screened by the Richmond Agitation-Sedation Scale and the Confusion Assessment Method for the intensive care unit from the first day after the operation, lasted 5 days. The risk factors of POD were analyzed by the Cox proportional hazard models.

Results: A total of 280 AAD patients were enrolled in this research, the incidence of POD was 37.86%. Adjusting for age, body mass index, and mechanical ventilation duration, multivariate Cox regression analysis model revealed that non-manual work (adjusted hazard ratio [AHR] = .554; 95% CI: 0.335-0.915; P = .021), Acute Physiology and Chronic Health Evaluation II (APACHE-II) scores > 20 (AHR = 3.359, 95% CI: 1.707-6.609, P < .001), hypoxemia (AHR = 1.846, 95% CI: 1.118-3.048, P = .017), and more than two types of analgesics and sedatives were independently associated with POD.

Conclusions: This study showed that risk factors independently associated with POD were APACHE-II score > 20, hypoxemia, and more types of analgesics and sedatives, and non-manual work was the protective factor.

Trial registration: This study was retrospectively registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR1900022408 ; Date: 2019/4/10).

Keywords: Aortic dissection; Postoperative delirium; Risk factors; Triple-branched stent graft implantation.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Patients’ flow chart
Fig. 2
Fig. 2
Composition ratio of POD in different periods of patients
See this image and copyright information in PMC

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