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[心脏外科手术患者术前睡眠障碍的特征及相关因素]

[Characteristics and correlated factors of preoperative sleep disorders in cardiac surgical patients].

作者信息

He M, Lai Y Q, Zhang X W, Xu B, Ma Z J, Zhang Q G, Song W T, Yang X B, Hua K, Cui H, Lei X, Wang Y X, Ma C C, Zhang Z H, Wang X Y, Cai L J, Shen S, Xu H

机构信息

Department of Structural Cardiology Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.

Nursing Department of Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2024 Oct 29;104(40):3745-3750. doi: 10.3760/cma.j.cn112137-20240410-00839.

DOI:10.3760/cma.j.cn112137-20240410-00839
PMID:39463368
Abstract

To investigate the clinical characteristics and correlated factors of preoperative sleep disorders in patients undergoing various types of cardiac surgery. The data of patients at the Structural Heart Surgery Center of Beijing Anzhen Hospital, Capital Medical University, from April 2023 to February 2024 were retrospectively collected. Patients were categorized into five groups based on cardiac surgical diagnosis: coronary heart disease, valvular disease, large vessel disease, congenital heart disease, and others. Each group was further subdivided into normal sleep (NS) and sleep disorder (SD) groups based on the Pittsburgh Sleep Quality Index (PSQI) scores. Demographic information, cognitive function, psychiatric symptoms, and other relevant data were collected. Clinical characteristics were compared between groups, and factors associated with preoperative sleep disorders were analyzed using multivariate logistic regression. A total of 1 016 patients aged (58.6±12.7) years were included in the study, including 701 males and 315 females. The incidence of SD was 45.6% (463/1 016). Multivariate logistic regression analysis showed that aging was a risk factor for sleep disorders in patients with coronary heart disease (=1.050, 95%: 1.026-1.077) and valvular disease (=1.033, 95%: 1.013-1.053). High Self-rating Depression Scale (SDS) score was a risk factor for sleep disorders in patients with valvular disease (=1.050, 95%: 1.013-1.091). High score on the Montreal Cognitive Assessment (MoCA) subitem-abstraction ability was a protective factor for sleep disorders in patients with coronary heart disease (=0.695, 95%: 0.490-0.981). The risk factors of preoperative sleep disorders in cardiac surgery patients vary based on the type of cardiac disease. Aging, depression and abstraction ability correlate with sleep disorders in cardiac surgical patients.

摘要

探讨各类心脏手术患者术前睡眠障碍的临床特征及相关因素。回顾性收集了首都医科大学附属北京安贞医院结构性心脏病外科中心2023年4月至2024年2月患者的数据。根据心脏外科诊断将患者分为五组:冠心病、瓣膜病、大血管疾病、先天性心脏病和其他。根据匹兹堡睡眠质量指数(PSQI)评分,每组再进一步细分为正常睡眠(NS)组和睡眠障碍(SD)组。收集人口统计学信息、认知功能、精神症状及其他相关数据。比较各组间的临床特征,并采用多因素logistic回归分析术前睡眠障碍的相关因素。本研究共纳入1016例年龄为(58.6±12.7)岁的患者,其中男性701例,女性315例。睡眠障碍的发生率为45.6%(463/1016)。多因素logistic回归分析显示,年龄增长是冠心病患者(=1.050,95%:1.026 - 1.077)和瓣膜病患者(=1.033,95%:1.013 - 1.053)睡眠障碍的危险因素。高抑郁自评量表(SDS)评分是瓣膜病患者睡眠障碍的危险因素(=1.050,95%:1.013 - 1.091)。蒙特利尔认知评估(MoCA)分项——抽象能力高分是冠心病患者睡眠障碍的保护因素(=0.695,95%:0.490 - 0.981)。心脏手术患者术前睡眠障碍的危险因素因心脏病类型而异。年龄增长、抑郁和抽象能力与心脏手术患者的睡眠障碍相关。

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