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Gender Differences and Postoperative Delirium in Adult Patients Undergoing Cardiac Valve Surgery

Background: Postoperative delirium (POD) is common in patients following cardiac surgery. According to studies on non-cardiac surgery, males suffered from higher incidence of POD. However, there is no report about effect of gender differences on POD occurrence in cardiac surgery patients. The aim of...

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Autores principales: Wang, Hongbai, Guo, Xiaoxiao, Zhu, Xianlin, Li, Yinan, Jia, Yuan, Zhang, Zhe, Yuan, Su, Yan, Fuxia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649844/
https://www.ncbi.nlm.nih.gov/pubmed/34888363
http://dx.doi.org/10.3389/fcvm.2021.751421
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author Wang, Hongbai
Guo, Xiaoxiao
Zhu, Xianlin
Li, Yinan
Jia, Yuan
Zhang, Zhe
Yuan, Su
Yan, Fuxia
author_facet Wang, Hongbai
Guo, Xiaoxiao
Zhu, Xianlin
Li, Yinan
Jia, Yuan
Zhang, Zhe
Yuan, Su
Yan, Fuxia
author_sort Wang, Hongbai
collection PubMed
description Background: Postoperative delirium (POD) is common in patients following cardiac surgery. According to studies on non-cardiac surgery, males suffered from higher incidence of POD. However, there is no report about effect of gender differences on POD occurrence in cardiac surgery patients. The aim of this study was to investigate the effect of gender differences on POD occurrence in adult patients after cardiac valve surgery. Methods: This is a retrospective case-control study. We recorded the clinical data in adult patients who underwent elective cardiac valve surgery from May 2019 to October 2020. POD was assessed by the Confusion Assessment Method for Intensive Care Unit. Univariate analysis was used to screen the potential risk factors. Collinearity analysis was conducted to detect overlapping predictor variables on the outcomes. A multivariate logistic regression with odds ratio (OR) and 95% confidence interval (CI) was used to identify the independent risk factors. The Hosmer-Lemeshow test was performed to show the good calibration of the logistic regression model. Results: In total, we recorded the perioperative data in 431 adult patients, including 212 males and 219 females. Sixty patients suffered from POD, including 39 males and 21 females. Twenty-one perioperative variables were selected, and 11 were screened by univariate analysis. We did not detect the severe collinearity among the 11 variables. Male gender was identified as a significant risk factor in POD occurrence in patients undergoing cardiac surgery (Adjusted OR: 2.213, 95% CI: 1.049–4.670, P = 0.037). The Hosmer-Lemeshow test demonstrated good calibration of the logistic regression model (χ(2) = 7.238, P = 0.511). Besides, compared with females, the relationship of male and delirium subtypes was as follows: (1) hyperactive: adjusted OR: 3.384, 95% CI: 1.335–8.580, P = 0.010; (2) hypoactive: adjusted OR: 0.509, 95% CI: 0.147–1.766, P = 0.287. A Stratification analysis by age demonstrated that the males showed higher POD incidence in patients aged younger than 60 years (adjusted OR: 4.384, 95% CI: 1.318–14.586, P = 0.016). Conclusions: Male gender is an important risk factor in POD occurrence in patients following cardiac surgery. Furthermore, the incidence of hyperactive delirium is higher in males. Besides, the male patients aged younger than 60 years are at high risk of POD. We should pay more attention to the male patients to prevent their POD occurrence.
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spelling pubmed-86498442021-12-08 Gender Differences and Postoperative Delirium in Adult Patients Undergoing Cardiac Valve Surgery Wang, Hongbai Guo, Xiaoxiao Zhu, Xianlin Li, Yinan Jia, Yuan Zhang, Zhe Yuan, Su Yan, Fuxia Front Cardiovasc Med Cardiovascular Medicine Background: Postoperative delirium (POD) is common in patients following cardiac surgery. According to studies on non-cardiac surgery, males suffered from higher incidence of POD. However, there is no report about effect of gender differences on POD occurrence in cardiac surgery patients. The aim of this study was to investigate the effect of gender differences on POD occurrence in adult patients after cardiac valve surgery. Methods: This is a retrospective case-control study. We recorded the clinical data in adult patients who underwent elective cardiac valve surgery from May 2019 to October 2020. POD was assessed by the Confusion Assessment Method for Intensive Care Unit. Univariate analysis was used to screen the potential risk factors. Collinearity analysis was conducted to detect overlapping predictor variables on the outcomes. A multivariate logistic regression with odds ratio (OR) and 95% confidence interval (CI) was used to identify the independent risk factors. The Hosmer-Lemeshow test was performed to show the good calibration of the logistic regression model. Results: In total, we recorded the perioperative data in 431 adult patients, including 212 males and 219 females. Sixty patients suffered from POD, including 39 males and 21 females. Twenty-one perioperative variables were selected, and 11 were screened by univariate analysis. We did not detect the severe collinearity among the 11 variables. Male gender was identified as a significant risk factor in POD occurrence in patients undergoing cardiac surgery (Adjusted OR: 2.213, 95% CI: 1.049–4.670, P = 0.037). The Hosmer-Lemeshow test demonstrated good calibration of the logistic regression model (χ(2) = 7.238, P = 0.511). Besides, compared with females, the relationship of male and delirium subtypes was as follows: (1) hyperactive: adjusted OR: 3.384, 95% CI: 1.335–8.580, P = 0.010; (2) hypoactive: adjusted OR: 0.509, 95% CI: 0.147–1.766, P = 0.287. A Stratification analysis by age demonstrated that the males showed higher POD incidence in patients aged younger than 60 years (adjusted OR: 4.384, 95% CI: 1.318–14.586, P = 0.016). Conclusions: Male gender is an important risk factor in POD occurrence in patients following cardiac surgery. Furthermore, the incidence of hyperactive delirium is higher in males. Besides, the male patients aged younger than 60 years are at high risk of POD. We should pay more attention to the male patients to prevent their POD occurrence. Frontiers Media S.A. 2021-11-23 /pmc/articles/PMC8649844/ /pubmed/34888363 http://dx.doi.org/10.3389/fcvm.2021.751421 Text en Copyright © 2021 Wang, Guo, Zhu, Li, Jia, Zhang, Yuan and Yan. https://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 Cardiovascular Medicine
Wang, Hongbai
Guo, Xiaoxiao
Zhu, Xianlin
Li, Yinan
Jia, Yuan
Zhang, Zhe
Yuan, Su
Yan, Fuxia
Gender Differences and Postoperative Delirium in Adult Patients Undergoing Cardiac Valve Surgery
title Gender Differences and Postoperative Delirium in Adult Patients Undergoing Cardiac Valve Surgery
title_full Gender Differences and Postoperative Delirium in Adult Patients Undergoing Cardiac Valve Surgery
title_fullStr Gender Differences and Postoperative Delirium in Adult Patients Undergoing Cardiac Valve Surgery
title_full_unstemmed Gender Differences and Postoperative Delirium in Adult Patients Undergoing Cardiac Valve Surgery
title_short Gender Differences and Postoperative Delirium in Adult Patients Undergoing Cardiac Valve Surgery
title_sort gender differences and postoperative delirium in adult patients undergoing cardiac valve surgery
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649844/
https://www.ncbi.nlm.nih.gov/pubmed/34888363
http://dx.doi.org/10.3389/fcvm.2021.751421
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