Schneider Frank, Böhner Hinrich, Habel Ute, Salloum Jasmin B, Stierstorfer Anselm, Hummel Thomas C, Miller Caeser, Friedrichs Ralf, Müller Eckhard E, Sandmann Wilhelm
Department of Psychiatry and Psychotherapy, Heinrich-Heine-University Düsseldorf, Bergische Landstr. 2, D-40629, Düsseldorf, Germany.
Gen Hosp Psychiatry. 2002 Jan-Feb;24(1):28-34. doi: 10.1016/s0163-8343(01)00168-2.
The aim of this study was to identify psychiatric and somatic risk factors associated with the development, severity and duration of postoperative delirium after vascular surgery. Forty-seven patients underwent aortic, carotid artery and peripheral artery surgery. Both, surgeon and psychiatrist, monitored patients preoperatively with daily follow up. Preoperative psychiatric assessment included standardized psychopathological scales for the detection of psychiatric symptoms and cognitive deficits. We diagnosed delirium using DSM IV criteria. Delirium Rating Scale was used to estimate delirium severity. Surgical parameters included patient history, diagnoses, medication and laboratory parameters. A statistical analysis was performed using multivariate regression analyses to find factors significantly associated with delirium development, severity, and duration. Thirty-six percent of the patients developed postoperative delirium after surgery. Comparison of different parameters revealed that especially preoperative depression symptoms and perioperative transfusions/infusions had significant predictive value for the development as well as for the severity of postoperative delirium.
本研究的目的是确定与血管手术后谵妄的发生、严重程度和持续时间相关的精神和躯体风险因素。47例患者接受了主动脉、颈动脉和外周动脉手术。外科医生和精神科医生在术前对患者进行每日随访监测。术前精神评估包括用于检测精神症状和认知缺陷的标准化精神病理量表。我们使用DSM-IV标准诊断谵妄。谵妄评定量表用于评估谵妄的严重程度。手术参数包括患者病史、诊断、用药和实验室参数。采用多因素回归分析进行统计分析，以找出与谵妄发生、严重程度和持续时间显著相关的因素。36%的患者术后发生谵妄。不同参数的比较显示，尤其是术前抑郁症状以及围手术期输血/输液对术后谵妄的发生和严重程度具有显著的预测价值。
