Wellstar School of Nursing, Kennesaw State University, Kennesaw, GA.
Center for Nursing Research, College of Nursing, East Tennessee State University, Johnson City, TN.
J Perianesth Nurs. 2021 Feb;36(1):41-46. doi: 10.1016/j.jopan.2020.06.015. Epub 2020 Oct 14.
The purpose of this study was to investigate associations between postoperative delirium (POD) and unplanned perioperative hypothermia (UPH) among adults undergoing noncardiac surgery.
A retrospective, exploratory design was used.
A retrospective, exploratory study was conducted using electronic medical record data abstracted from a purposive convenience sample of adult patients undergoing noncardiac surgery from January 2014 to June 2017.
The analyzed data set included 22,548 surgeries, of which 9% experienced POD. Logistic regression indicated that American Society of Anesthesiologists (ASA) class was the strongest predictor of POD (χ = 1,207.11, df = 4, inclusive of all ASA class terms). A significant relationship between UPH and POD (χ = 54.94, df = 4, inclusive of all UPH terms) and a complex relationship among UPH, patient age, ASA class, and POD were also found.
Results support a relationship between UPH and POD. Notably, there is also a complex relationship in the noncardiac surgery population among UPH, age, ASA class, and POD. Preliminary understanding of this relationship is based on the pathophysiological response to surgical stress. Further research is indicated.
本研究旨在探讨成年人接受非心脏手术后术后谵妄(POD)与计划性围手术期低体温(UPH)之间的关联。
采用回顾性、探索性设计。
使用 2014 年 1 月至 2017 年 6 月期间,从接受非心脏手术的成年患者的目的便利抽样中提取的电子病历数据,进行回顾性探索性研究。
分析的数据集中包括 22548 例手术,其中 9%的患者发生了 POD。逻辑回归表明,美国麻醉师协会(ASA)分级是 POD 的最强预测因子(χ²=1207.11,df=4,包含所有 ASA 分级术语)。UPH 与 POD 之间存在显著关系(χ²=54.94,df=4,包含所有 UPH 术语),并且在 UPH、患者年龄、ASA 分级和 POD 之间存在复杂的关系。
结果支持 UPH 与 POD 之间的关系。值得注意的是,在非心脏手术人群中,UPH、年龄、ASA 分级和 POD 之间也存在复杂的关系。对这种关系的初步了解是基于对手术应激的病理生理反应。需要进一步研究。