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心脏手术患者术后谵妄的预测模型

Predictive model for postoperative delirium in cardiac surgical patients.

作者信息

Afonso Anoushka, Scurlock Corey, Reich David, Raikhelkar Jayashree, Hossain Sabera, Bodian Carol, Krol Marina, Flynn Brigid

机构信息

Mount Sinai School of Medicine, New York, NY 10029, USA.

出版信息

Semin Cardiothorac Vasc Anesth. 2010 Sep;14(3):212-7. doi: 10.1177/1089253210374650. Epub 2010 Jul 20.

Abstract

Delirium is a common complication following cardiac surgery, and the predictors of delirium remain unclear. The authors performed a prospective observational analysis to develop a predictive model for postoperative delirium using demographic and procedural parameters. A total of 112 adult postoperative cardiac surgical patients were evaluated twice daily for delirium using the Richmond Agitation-Sedation Scale (RASS) and Confusion Assessment Model for the ICU (CAM-ICU). The incidence of delirium was 34% (n = 38). Increased age (odds ratio [OR] = 2.5; 95% confidence interval [CI] = 1.6-3.9; P < .0001, per 10 years) and increased duration of surgery (OR = 1.3; 95% CI = 1.1-1.5; P = .0002, per 30 minutes) were independently associated with postoperative delirium. Gender, BMI, diabetes mellitus, preoperative ejection fraction, surgery type, length of cardiopulmonary bypass, intraoperative blood component administration, Acute Physiology and Chronic Health Evaluation II score, Sequential Organ Failure Assessment score, and Charlson Comorbidity Index, were not independently associated with postoperative delirium.

摘要

谵妄是心脏手术后常见的并发症,其预测因素仍不明确。作者进行了一项前瞻性观察分析,以利用人口统计学和手术参数建立术后谵妄的预测模型。使用里士满躁动镇静量表(RASS)和重症监护病房意识模糊评估法(CAM-ICU),每天对112例成年心脏手术术后患者进行两次谵妄评估。谵妄发生率为34%(n = 38)。年龄增加(比值比[OR]=2.5;95%置信区间[CI]=1.6 - 3.9;P <.0001,每增加10岁)和手术时间延长(OR = 1.3;95%CI = 1.1 - 1.5;P =.0002,每增加30分钟)与术后谵妄独立相关。性别、体重指数、糖尿病、术前射血分数、手术类型、体外循环时间、术中血液成分输注、急性生理与慢性健康状况评分系统II评分、序贯器官衰竭评估评分以及查尔森合并症指数与术后谵妄无独立相关性。

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