Shadvar Kamran, Baastani Farzaneh, Mahmoodpoor Ata, Bilehjani Eissa
Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
J Cardiovasc Thorac Res. 2013;5(4):157-61. doi: 10.5681/jcvtr.2013.034. Epub 2013 Dec 5.
Delirium is defined as an acute cognitive disorder presenting with fluctuation in cognition, apathy and non-organized thinking. It may increase morbidity, mortality, ICU stay and cost. In patients who underwent heart surgery delirium may increase post-operative complications such as respiratory insufficiency, sternum instability and need to re-operation of the sternum. The aim of this study was to evaluate the prevalence and risk factors of delirium in patients admitted to cardiac surgery.
18 years or older patients who had undergone cardiac surgeries and stayed for more than 24 hours in ICU following surgery were recruited. All subjects were assessed for signs & symptoms of delirium using CAM-ICU and its risk factors. All data were analyzed by SPSS 16 at the end of the study.
The prevalence of delirium in these patients was 23.5% (47 patients). The mean age of patients with delirium was more than other patients (P=0.001). The Incidence of delirium in the patients with cardiopulmonary bypass surgery (CPB) was higher than the patients without CPB (P=0.01). The Incidence of delirium in the patients with Atrial fibrillation was higher than patients without it (P=0.002). The Incidence of delirium in the patients with CVA history was higher than the patients without CVA history (P=0.032). The mean time of mechanical ventilation in the delirious patients was more than other patients (P=0.01).
Older Age, CPB, history of CVA, Atrial Fibrillation, and prolonged mechanical ventilation are considered as the risk factors of delirium in cardiac surgery patients.
谵妄被定义为一种急性认知障碍，表现为认知波动、淡漠和思维紊乱。它可能会增加发病率、死亡率、重症监护病房（ICU）住院时间和费用。在接受心脏手术的患者中，谵妄可能会增加术后并发症的发生，如呼吸功能不全、胸骨不稳定以及需要进行胸骨再次手术。本研究的目的是评估心脏手术患者谵妄的患病率及危险因素。
招募年龄在18岁及以上、接受过心脏手术且术后在ICU停留超过24小时的患者。使用CAM-ICU评估所有受试者的谵妄体征和症状及其危险因素。在研究结束时，所有数据均采用SPSS 16进行分析。
这些患者中谵妄的患病率为23.5%（47例患者）。谵妄患者的平均年龄高于其他患者（P=0.001）。接受体外循环手术（CPB）的患者谵妄发生率高于未接受CPB的患者（P=0.01）。患有心房颤动的患者谵妄发生率高于未患心房颤动的患者（P=0.002）。有脑血管意外（CVA）病史的患者谵妄发生率高于无CVA病史的患者（P=0.032）。谵妄患者的机械通气平均时间长于其他患者（P=0.01）。
高龄、CPB、CVA病史、心房颤动和机械通气时间延长被认为是心脏手术患者谵妄的危险因素。
