Breu Anita, Stransky Melanie, Metterlein Thomas, Werner Tilmann, Trabold Benedikt
Department of Anaesthesiology , University Hospital Regensburg , Germany.
Scand Cardiovasc J. 2015 Aug;49(4):207-12. doi: 10.3109/14017431.2015.1041423. Epub 2015 May 7.
To evaluate the incidence of subsyndromal delirium (SSD) after cardiac surgery and its impact on clinical outcome.
In this prospective study, 506 patients were screened for SSD and clinical delirium (CD) using the Intensive Care Delirium Screening Checklist.
150 (34%) patients were classified as having SSD and 54 (12%) patients as having CD. 2% of SSD patients developed CD. Patients' age, EuroSCORE, postoperative the Acute Physiology and Chronic Health Evaluation II, the incidences of emergency operations, and the number of aortic surgery increased from non-delirious (ND) to SSD. Intensive care unit (ICU) and hospital stays were longer in CD compared with SSD patients. ND patients did not differ from SSD patients regarding duration of ventilation, ICU stay, or hospital stay. The rate of home discharge decreased from ND over SSD to CD patients. Mortality in SSD patients did not differ from ND or CD patients.
SSD showed a prevalence of 34% in patients after cardiac surgery. SSD occurred independent of CD for the majority of patients. Except for a lower rate of home discharge, the clinical outcome did not differ from that of ND patients. According to our data, SSD does not represent a preliminary or resolving stage of delirium.
评估心脏手术后亚综合征谵妄（SSD）的发生率及其对临床结局的影响。
在这项前瞻性研究中，使用重症监护谵妄筛查清单对506例患者进行了SSD和临床谵妄（CD）筛查。
150例（34%）患者被分类为患有SSD，54例（12%）患者被分类为患有CD。2%的SSD患者发展为CD。患者的年龄、欧洲心脏手术风险评估系统（EuroSCORE）、术后急性生理与慢性健康状况评分系统II（APACHE II）、急诊手术发生率以及主动脉手术数量从无谵妄（ND）患者到SSD患者呈增加趋势。与SSD患者相比，CD患者的重症监护病房（ICU）和住院时间更长。ND患者在通气时间、ICU住院时间或住院时间方面与SSD患者无差异。从ND患者到SSD患者再到CD患者，出院回家的比例下降。SSD患者的死亡率与ND或CD患者无差异。
SSD在心脏手术后患者中的患病率为34%。对于大多数患者，SSD独立于CD发生。除出院回家比例较低外，其临床结局与ND患者无异。根据我们的数据，SSD并不代表谵妄的初始或缓解阶段。
