Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven - University of Leuven, Kapucijnenvoer 35/4, B-3000, Leuven, Belgium.
Department of Geriatric Medicine, KU Leuven - University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium.
BMC Geriatr. 2020 Nov 18;20(1):478. doi: 10.1186/s12877-020-01872-6.
Although many studies have reported numerous risk factors for postoperative delirium, data are scarce about preoperative anxiety as a risk factor. The study aimed to investigate the association between preoperative anxiety and postoperative delirium in older patients undergoing cardiac surgery.
Secondary data analysis of a randomized, observer-blind, controlled trial. A total of 190 patients 65 years or older and admitted to the intensive care unit and cardiac surgery unit of a university hospital scheduled for elective on-pump cardiac surgery were included. State anxiety was measured preoperatively using the Amsterdam Preoperative Anxiety and Information Scale and the Visual Analogue Scale for anxiety. Incidence of delirium was measured during the first 5 postoperative days using the Confusion Assessment Method for Intensive Care Unit (when ventilated), or the 3 Minute Diagnostic Interview for Confusion Assessment Method (when extubated) and by daily chart review.
Preoperative state anxiety was reported by 31% of the patients and 41% had postoperative delirium. A multiple step logistic regression analyses revealed no association between preoperative anxiety and postoperative delirium. Significant risk factors for postoperative delirium were age (OR = 1.10, 95% CI (1.03-1.18)), activities of daily living (0.69, 95% CI (0.50-0.96)), diabetes mellitus (OR = 3.15, 95% CI (1.42-7.00)) and time on cardiopulmonary bypass (OR = 1.01, 95% CI (1.00 to 1.02)).
No relationship could be found between preoperative anxiety and postoperative delirium.
尽管许多研究报告了许多术后谵妄的风险因素，但术前焦虑作为风险因素的数据却很少。本研究旨在探讨老年心脏手术患者术前焦虑与术后谵妄的关系。
这是一项随机、观察者盲法、对照试验的二次数据分析。共纳入 190 名 65 岁或以上、拟行体外循环择期心脏手术的患者，他们被收入大学医院的重症监护病房和心脏外科病房。术前使用阿姆斯特丹术前焦虑和信息量表和焦虑视觉模拟量表测量状态焦虑。术后第 1 天至第 5 天使用 ICU 意识混乱评估方法（通气时）或 3 分钟诊断性意识混乱评估方法（拔管时）和每日图表审查来测量谵妄的发生率。
31%的患者报告有术前状态焦虑，41%的患者发生术后谵妄。多步逻辑回归分析显示，术前焦虑与术后谵妄之间无关联。术后谵妄的显著危险因素是年龄（OR=1.10，95%CI（1.03-1.18））、日常生活活动能力（0.69，95%CI（0.50-0.96））、糖尿病（OR=3.15，95%CI（1.42-7.00））和体外循环时间（OR=1.01，95%CI（1.00-1.02））。
未发现术前焦虑与术后谵妄之间存在关系。
