Princess Muna College of Nursing, Mutah University, Amman, Jordan.
School of Nursing, University of Jordan, Amman, Jordan.
Nurs Crit Care. 2021 May;26(3):150-155. doi: 10.1111/nicc.12492. Epub 2019 Dec 10.
Post-operative delirium among cardiac surgery patients is a prevalent complication that associated with multiple negative outcomes.
This study aimed to assess delirium incidence, associated factors, and outcomes for adult patients who underwent elective cardiac surgery.
An exploratory prospective cohort design was used for this study.
Delirium was diagnosed by the Confusion Assessment Method for the Intensive Care Unit. Incidence, preoperative, intraoperative, and post-operative variables for 245 patients during 3-month period were collected and analysed.
Delirium developed in 9% (n = 22) of the sample. Patients with delirium were significantly older (mean age = 65.7, SD = 8.1), t (243) = -3.66, P < .05); had longer surgery time (mean time = 286.3, SD = 82.2), t (243) = -2.25, P < .05); received more blood post-surgery (t (243) = -3.86, P < .05); spent more time on mechanical ventilation (t [21.6] = -2.2, P < .05); had longer critical care unit stay (t [21.7] = -4.0, P < 0.05); and had longer hospitalization than patients without delirium.
The risk factors associated with development of delirium were advanced age and increased duration of surgery. Negative outcomes associated with delirium were increased duration of mechanical ventilation, increased volume of post-operative infused colloids and blood/products, increased critical care unit stay, and increased hospitalization. A multifactorial model for delirium risk factors should be considered to detect and work on potentially preventable delirium factors.
Post-cardiac surgery delirium leads to longer mechanical ventilation time, increased ICU stay, and prolonged hospitalization. Delirium post-cardiac surgery is potentially preventable with appropriate identification of risk factors by nurses.
心脏手术后患者出现谵妄是一种普遍的并发症，与多种不良后果相关。
本研究旨在评估择期心脏手术后成年患者谵妄的发生率、相关因素和结局。
本研究采用探索性前瞻性队列设计。
采用重症监护谵妄评估方法诊断谵妄。在 3 个月期间收集并分析了 245 例患者的谵妄发生率、术前、术中及术后变量。
样本中 9%（n=22）发生了谵妄。谵妄患者年龄显著更大（平均年龄 65.7，标准差 8.1），t（243）=-3.66，P<.05）；手术时间更长（平均时间 286.3，标准差 82.2），t（243）=-2.25，P<.05）；术后接受更多的血液制品（t（243）=-3.86，P<.05）；机械通气时间更长（t [21.6]=-2.2，P<.05）；在重症监护病房停留时间更长（t [21.7]=-4.0，P<.05）；住院时间也长于无谵妄患者。
与谵妄发生相关的危险因素是年龄较大和手术时间延长。谵妄相关的不良结局是机械通气时间延长、术后输注胶体和血液制品/产品量增加、重症监护病房停留时间延长和住院时间延长。应考虑建立谵妄危险因素的多因素模型，以发现并针对潜在可预防的谵妄因素进行干预。
心脏手术后谵妄导致机械通气时间延长、ICU 停留时间延长和住院时间延长。通过护士适当识别危险因素，可以预防心脏手术后谵妄。
