Xue Xiaofei, Wang Pei, Wang Jingjing, Li Xian, Peng Fei, Wang Zhinong
Center for Comprehensive Treatment of Atrial Fibrillation, Department of Cardiothoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
Department of Nursing, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
J Thorac Dis. 2020 May;12(5):2188-2196. doi: 10.21037/jtd.2020.04.26.
Postoperative delirium dramatically increases the mortality and morbidity of patients undergoing cardiac surgery. Preoperative education has been proven to be effective in improving recovery and reducing complications. However, there is rare evidence of individualized education for the delirium. This study aimed to investigate the effect of preoperative personalized education on postoperative delirium of patients undergoing cardiac surgery.
A total of 133 adult patients receiving cardiac surgery in a single center were enrolled in this study and randomized into the experimental group (n=67) and the control group (n=66), who were given the preoperative individualized education intervention and routine care respectively. The primary endpoint of delirium and other clinical outcomes were observed and compared.
All patients completed this trial without a significant difference between the two groups in baseline characteristics. The incidence of the delirium of the experimental group was significantly lower than that of the control group (10.4% 24.2%, P=0.038). There was no statistical difference between two groups in hospital-stay and other complications, while the mechanical ventilation time and ICU stay of the experimental group was significantly lower (MV time: 13.7±7.6 18.6±9.8 h, P=0.002; ICU stay: 31.3±9.1 36.5±10.4 h, P=0.003).
Preoperative individualized education intervention can reduce the incidence of postoperative delirium and promote the recovery of patients receiving cardiac surgery.
术后谵妄显著增加心脏手术患者的死亡率和发病率。术前教育已被证明对促进康复和减少并发症有效。然而，针对谵妄的个性化教育证据很少。本研究旨在探讨术前个性化教育对心脏手术患者术后谵妄的影响。
本研究纳入了在单一中心接受心脏手术的133例成年患者，随机分为实验组（n = 67）和对照组（n = 66），分别给予术前个性化教育干预和常规护理。观察并比较谵妄的主要终点及其他临床结局。
所有患者均完成本试验，两组基线特征无显著差异。实验组谵妄发生率显著低于对照组（10.4%对24.2%，P = 0.038）。两组住院时间及其他并发症无统计学差异，但实验组机械通气时间和重症监护病房停留时间显著缩短（机械通气时间：13.7±7.6对18.6±9.8小时，P = 0.002；重症监护病房停留时间：31.3±9.1对36.5±10.4小时，P = 0.003）。
术前个性化教育干预可降低心脏手术患者术后谵妄的发生率，促进患者康复。
