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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...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2020
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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. |
format | Online Article Text |
id | pubmed-7544982 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
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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