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

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...

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Autores principales: Lin, Yanjuan, Chen, Qiong, Zhang, Haoruo, Chen, Liang-Wan, Peng, Yanchun, Huang, Xizhen, Chen, Yiping, Li, Sailan, Lin, Lingyu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7362546/
https://www.ncbi.nlm.nih.gov/pubmed/32664963
http://dx.doi.org/10.1186/s13019-020-01217-9
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author Lin, Yanjuan
Chen, Qiong
Zhang, Haoruo
Chen, Liang-Wan
Peng, Yanchun
Huang, Xizhen
Chen, Yiping
Li, Sailan
Lin, Lingyu
author_facet Lin, Yanjuan
Chen, Qiong
Zhang, Haoruo
Chen, Liang-Wan
Peng, Yanchun
Huang, Xizhen
Chen, Yiping
Li, Sailan
Lin, Lingyu
author_sort Lin, Yanjuan
collection PubMed
description 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).
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spelling pubmed-73625462020-07-17 Risk factors for postoperative delirium in patients with triple-branched stent graft implantation Lin, Yanjuan Chen, Qiong Zhang, Haoruo Chen, Liang-Wan Peng, Yanchun Huang, Xizhen Chen, Yiping Li, Sailan Lin, Lingyu J Cardiothorac Surg Research Article 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). BioMed Central 2020-07-14 /pmc/articles/PMC7362546/ /pubmed/32664963 http://dx.doi.org/10.1186/s13019-020-01217-9 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Lin, Yanjuan
Chen, Qiong
Zhang, Haoruo
Chen, Liang-Wan
Peng, Yanchun
Huang, Xizhen
Chen, Yiping
Li, Sailan
Lin, Lingyu
Risk factors for postoperative delirium in patients with triple-branched stent graft implantation
title Risk factors for postoperative delirium in patients with triple-branched stent graft implantation
title_full Risk factors for postoperative delirium in patients with triple-branched stent graft implantation
title_fullStr Risk factors for postoperative delirium in patients with triple-branched stent graft implantation
title_full_unstemmed Risk factors for postoperative delirium in patients with triple-branched stent graft implantation
title_short Risk factors for postoperative delirium in patients with triple-branched stent graft implantation
title_sort risk factors for postoperative delirium in patients with triple-branched stent graft implantation
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7362546/
https://www.ncbi.nlm.nih.gov/pubmed/32664963
http://dx.doi.org/10.1186/s13019-020-01217-9
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