Jodati Ahmadreza, Safaie Nasser, Raoofi Mohammadbagher, Ghorbani Ladan, Ranjbar Fatemeh, Noorazar Golamreza, Mosharkesh Majid
Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
J Cardiovasc Thorac Res. 2013;5(3):97-9. doi: 10.5681/jcvtr.2013.021. Epub 2013 Oct 5.
Delirium as a relatively common complication following cardiac surgery remains a contributory factor in postoperative mortality and an obstacle to early discharge of patients.
In the present study 329 patients who underwent open heart surgery between 1st January 2008 to 1st January 2009 in Shahid Madani Heart Center, Tabriz, Iran were enrolled.
Overall 4.9% of patients developed delirium after cardiac surgery. We found atrial fibrillation (P = 0.005), lung diseases (P = 0.04) and hypertension (P = 0.02) to be more common in patients who develop delirium postoperatively. Furthermore, the length of intensive care unit (ICU) stay, cardiopulmonary bypass (CPB) time, and ventilation period were also significantly increased. Also a statistically meaningful relationship between the female gender and development of delirium was also noted (P = 0.02). On the other hand no meaningful relationship was detected between diabetes, history of cerebral vascular diseases, peripheral vascular diseases, myocardial infarction, development of pneumonia following surgery, and laboratory levels of sodium, potassium, glucose, and complete blood cell count (CBC) including white blood cells, red blood cells, platelets in the blood-hemoglobin and hematocrits. Also environmental factors like presence of other patients or companion with the patient, and objects like clock, window and calendar in the patient's room did not affect prevention of delirium.
Based on this and other investigations, it can be suggested to use MMPI test to recognize pathologic elements to prevented delirium after surgery and complementary treatment for coping with delirium.
谵妄作为心脏手术后相对常见的并发症,仍然是术后死亡率的一个促成因素以及患者早期出院的障碍。
在本研究中,纳入了2008年1月1日至2009年1月1日期间在伊朗大不里士的沙希德·马达尼心脏中心接受心脏直视手术的329例患者。
总体而言,4.9%的患者在心脏手术后发生谵妄。我们发现房颤(P = 0.005)、肺部疾病(P = 0.04)和高血压(P = 0.02)在术后发生谵妄的患者中更为常见。此外,重症监护病房(ICU)住院时间、体外循环(CPB)时间和通气时间也显著增加。还注意到女性性别与谵妄发生之间存在统计学意义的关系(P = 0.02)。另一方面,未发现糖尿病、脑血管疾病史、外周血管疾病、心肌梗死、术后肺炎的发生以及血液中钠、钾、葡萄糖的实验室水平和全血细胞计数(CBC)包括白细胞、红细胞、血小板、血红蛋白和血细胞比容之间存在有意义的关系。此外,诸如其他患者的存在或患者的陪伴以及患者房间里的时钟、窗户和日历等环境因素也不影响谵妄的预防。
基于本研究及其他调查,建议使用明尼苏达多相人格调查表(MMPI)测试来识别病理因素以预防术后谵妄,并采用辅助治疗来应对谵妄。