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Prevalence, Predictors, and Early Outcomes of Post-operative Delirium in Patients With Type A Aortic Dissection During Intensive Care Unit Stay

Objectives: The aim of this study was to investigate the prevalence and explore the predictors and early outcomes of post-operative delirium (POD) in patients with type A aortic dissection (AAD) during intensive care unit (ICU) stays. Methods: We retrospectively reviewed the records of 301 patients...

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Autores principales: Cai, Shining, Zhang, Xiaomin, Pan, Wenyan, Latour, Jos M., Zheng, Jili, Zhong, Jun, Gao, Jian, Lv, Minzhi, Luo, Zhe, Wang, Chunsheng, Zhang, Yuxia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7544982/
https://www.ncbi.nlm.nih.gov/pubmed/33072785
http://dx.doi.org/10.3389/fmed.2020.572581
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author Cai, Shining
Zhang, Xiaomin
Pan, Wenyan
Latour, Jos M.
Zheng, Jili
Zhong, Jun
Gao, Jian
Lv, Minzhi
Luo, Zhe
Wang, Chunsheng
Zhang, Yuxia
author_facet Cai, Shining
Zhang, Xiaomin
Pan, Wenyan
Latour, Jos M.
Zheng, Jili
Zhong, Jun
Gao, Jian
Lv, Minzhi
Luo, Zhe
Wang, Chunsheng
Zhang, Yuxia
author_sort Cai, Shining
collection PubMed
description Objectives: The aim of this study was to investigate the prevalence and explore the predictors and early outcomes of post-operative delirium (POD) in patients with type A aortic dissection (AAD) during intensive care unit (ICU) stays. Methods: We retrospectively reviewed the records of 301 patients with AAD who underwent surgical treatment in our institution from January 2017 to December 2018. Results: Delirium developed in 73 patients (24.25%) during the ICU stay. Patients with lower estimated glomerular filtration rates [odds ratio (OR) 0.84, 95% CI 0.74–0.94, p = 0.003], post-operative midazolam use (OR 2.37, 95% CI 1.33–4.23, p = 0.004), and post-operative morphine use (OR 1.87, 95% CI 1.07–3.29, p = 0.029) were more susceptible to developing POD. Patients who developed POD had a longer ICU stay (11.52 vs. 7.22 days, p < 0.001) and hospital stay (23.99 vs. 18.91, p = 0.007) with higher hospitalization costs (48.82 vs. 37.66 thousand dollars, p < 0.001) than those without POD. The in-hospital mortality rate was higher in the delirium group, but the difference was not significant (6.85 vs. 4.82%, p = 0.502). Conclusions: The incidence of POD in patients with AAD was high and was associated with renal dysfunction and the use of midazolam and morphine. POD was associated with poor early outcomes, suggesting the importance of early screening, such as for renal dysfunction, and prevention by using sedation scales to minimize the use of midazolam and morphine in these patients.
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spelling pubmed-75449822020-10-17 Prevalence, Predictors, and Early Outcomes of Post-operative Delirium in Patients With Type A Aortic Dissection During Intensive Care Unit Stay Cai, Shining Zhang, Xiaomin Pan, Wenyan Latour, Jos M. Zheng, Jili Zhong, Jun Gao, Jian Lv, Minzhi Luo, Zhe Wang, Chunsheng Zhang, Yuxia Front Med (Lausanne) Medicine Objectives: The aim of this study was to investigate the prevalence and explore the predictors and early outcomes of post-operative delirium (POD) in patients with type A aortic dissection (AAD) during intensive care unit (ICU) stays. Methods: We retrospectively reviewed the records of 301 patients with AAD who underwent surgical treatment in our institution from January 2017 to December 2018. Results: Delirium developed in 73 patients (24.25%) during the ICU stay. Patients with lower estimated glomerular filtration rates [odds ratio (OR) 0.84, 95% CI 0.74–0.94, p = 0.003], post-operative midazolam use (OR 2.37, 95% CI 1.33–4.23, p = 0.004), and post-operative morphine use (OR 1.87, 95% CI 1.07–3.29, p = 0.029) were more susceptible to developing POD. Patients who developed POD had a longer ICU stay (11.52 vs. 7.22 days, p < 0.001) and hospital stay (23.99 vs. 18.91, p = 0.007) with higher hospitalization costs (48.82 vs. 37.66 thousand dollars, p < 0.001) than those without POD. The in-hospital mortality rate was higher in the delirium group, but the difference was not significant (6.85 vs. 4.82%, p = 0.502). Conclusions: The incidence of POD in patients with AAD was high and was associated with renal dysfunction and the use of midazolam and morphine. POD was associated with poor early outcomes, suggesting the importance of early screening, such as for renal dysfunction, and prevention by using sedation scales to minimize the use of midazolam and morphine in these patients. Frontiers Media S.A. 2020-09-25 /pmc/articles/PMC7544982/ /pubmed/33072785 http://dx.doi.org/10.3389/fmed.2020.572581 Text en Copyright © 2020 Cai, Zhang, Pan, Latour, Zheng, Zhong, Gao, Lv, Luo, Wang and Zhang. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Cai, Shining
Zhang, Xiaomin
Pan, Wenyan
Latour, Jos M.
Zheng, Jili
Zhong, Jun
Gao, Jian
Lv, Minzhi
Luo, Zhe
Wang, Chunsheng
Zhang, Yuxia
Prevalence, Predictors, and Early Outcomes of Post-operative Delirium in Patients With Type A Aortic Dissection During Intensive Care Unit Stay
title Prevalence, Predictors, and Early Outcomes of Post-operative Delirium in Patients With Type A Aortic Dissection During Intensive Care Unit Stay
title_full Prevalence, Predictors, and Early Outcomes of Post-operative Delirium in Patients With Type A Aortic Dissection During Intensive Care Unit Stay
title_fullStr Prevalence, Predictors, and Early Outcomes of Post-operative Delirium in Patients With Type A Aortic Dissection During Intensive Care Unit Stay
title_full_unstemmed Prevalence, Predictors, and Early Outcomes of Post-operative Delirium in Patients With Type A Aortic Dissection During Intensive Care Unit Stay
title_short Prevalence, Predictors, and Early Outcomes of Post-operative Delirium in Patients With Type A Aortic Dissection During Intensive Care Unit Stay
title_sort prevalence, predictors, and early outcomes of post-operative delirium in patients with type a aortic dissection during intensive care unit stay
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7544982/
https://www.ncbi.nlm.nih.gov/pubmed/33072785
http://dx.doi.org/10.3389/fmed.2020.572581
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