University of Rochester Medical Center, Department of Psychiatry, United States of America.
University of Rochester Medical Center, Department of Psychiatry, United States of America; U.S. Department of Veterans Affairs, Center of Excellence for Suicide Prevention, United States of America.
Gen Hosp Psychiatry. 2021 Jul-Aug;71:43-46. doi: 10.1016/j.genhosppsych.2021.04.005. Epub 2021 Apr 22.
The goal is to assess the feasibility of conducting unattended (type II) sleep studies before surgical aortic valve replacement (SAVR) to examine the relationship between baseline sleep measures and postoperative delirium.
This single-site study recruited 18 of 20 study referrals with aortic stenosis undergoing first lifetime SAVR. Subjects completed a home-based type II sleep study. Delirium was assessed postoperative days 1-5. Exact logistic regression was used to determine whether sleep efficiency or apnea/hypopnea index predicts delirium.
Of 18 study participants, 15 successfully completed a home sleep study (mean age: 71.7 +/- 8.1 years old; 10 male subjects). Five subjects (33.3%) developed delirium. Preliminary analyses found that greater sleep efficiency was associated with a large reduction in delirium odds but was not statistically significant (OR = 0.31, 95% CI: 0.06, 1.03, p = 0.057). The point estimate of the relationship between apnea/hypopnea index and delirium was not similarly sizeable (OR 1.10, 95% CI: 0.35, 3.37, p = 0.85).
Our findings suggest that home type II sleep studies before SAVR are feasible, and they support adequately powered studies investigating type II home sleep studies as a predictor of postoperative delirium and other important postsurgical outcomes.
评估在主动脉瓣置换术（SAVR）前进行无人值守（II 型）睡眠研究的可行性，以检查基线睡眠测量与术后谵妄之间的关系。
这项单站点研究招募了 20 名主动脉瓣狭窄患者中进行首次终身 SAVR 的 18 名研究转诊患者。患者完成了基于家庭的 II 型睡眠研究。术后第 1-5 天评估谵妄。确切的逻辑回归用于确定睡眠效率或呼吸暂停/低通气指数是否预测谵妄。
在 18 名研究参与者中，有 15 名成功完成了家庭睡眠研究（平均年龄：71.7 +/- 8.1 岁；10 名男性）。5 名患者（33.3%）发生谵妄。初步分析发现，睡眠效率较高与谵妄几率大幅降低相关，但无统计学意义（OR = 0.31，95%CI：0.06，1.03，p = 0.057）。呼吸暂停/低通气指数与谵妄之间关系的点估计也没有那么大（OR 1.10，95%CI：0.35，3.37，p = 0.85）。
我们的发现表明，SAVR 前的家庭 II 型睡眠研究是可行的，并且支持进行充分的研究，调查 II 型家庭睡眠研究作为术后谵妄和其他重要术后结局的预测因子。
