Fenta Efrem, Teshome Diriba, Kibret Simegnew, Hunie Metages, Tiruneh Abebe, Belete Amsalu, Molla Amsalu, Dessie Belayneh, Geta Kumlachew
Department of Anesthesia, College of Health Sciences, Debre Tabor University, PO. Box: 272, Debre Tabor, Ethiopia.
Department of Psychiatry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
Sci Rep. 2025 Jan 9;15(1):1400. doi: 10.1038/s41598-024-84554-2.
Postoperative delirium has the potential to impact individuals of all age groups, with a significant emphasis on the elderly population. Its presence leads to an increase in surgical morbidity and mortality rates, as well as a notable prolongation of hospital stays. However, there is a lack of research regarding the prevalence, risk factors, and implications of postoperative delirium in developing nations like Ethiopia, which affects both patients and healthcare institutions. An observational study was conducted at hospitals in the South Gondar Zone to diagnose postoperative delirium in the Post-Anesthesia Care Unit (PACU) using the Nursing Delirium Screening Scale. Both bivariable and multivariable logistic regression techniques were employed to analyze the association between independent factors and postoperative delirium. The strength of the association was indicated by the odds ratio with a 95% confidence interval (CI). Any p-values below 0.05 were considered statistically significant. The incidence of postoperative delirium was determined to be 41%. In the multivariate logistic regression analysis, several factors were identified as significantly associated with postoperative delirium. These factors include an age of 75 or older (AOR, 11.24; 95% CI, 4.74-26.65), ASA-PS IV (AOR, 3.25; 95% CI, 1.81-5.85), severe functional impairment of activities of daily living (AOR, 3.29; 95% CI, 1.06-10.20), premedication with benzodiazepine (AOR, 4.61; 95% CI, 2.48-8.57), intraoperative estimated blood loss exceeding 1000 ml (AOR, 2.74; 95% CI, 1.50-4.98), and intraoperative ketamine use (AOR, 3.84; 95% CI, 2.21-6.68). Additionally, postoperative delirium was found to significantly prolong the duration of stay in the post-anesthesia care unit (PACU) and the length of hospital stay (p-value < 0.05). Patients aged 75 or older, ASA-PS IV, experiencing severe functional impairment of ADL, patients premedicated with benzodiazepine, patients with intraoperative estimated blood loss exceeding 1000 ml, and intraoperative ketamine use were identified as risk factors for post-operative delirium.
术后谵妄有可能影响所有年龄组的个体，其中老年人群受到显著关注。它的出现会导致手术发病率和死亡率增加，以及住院时间显著延长。然而，在像埃塞俄比亚这样的发展中国家，关于术后谵妄的患病率、风险因素及其影响的研究匮乏，这对患者和医疗机构都会产生影响。在南贡德尔地区的医院进行了一项观察性研究，使用护理谵妄筛查量表在麻醉后护理单元（PACU）诊断术后谵妄。采用双变量和多变量逻辑回归技术分析独立因素与术后谵妄之间的关联。关联强度用比值比和95%置信区间（CI）表示。任何p值低于0.05都被认为具有统计学意义。术后谵妄的发生率确定为41%。在多变量逻辑回归分析中，确定了几个与术后谵妄显著相关的因素。这些因素包括75岁及以上的年龄（比值比，11.24；95%置信区间，4.74 - 26.65）、美国麻醉医师协会身体状况分级（ASA - PS）为IV级（比值比，3.25；95%置信区间，1.81 - 5.85）、日常生活活动严重功能障碍（比值比，3.29；95%置信区间，1.06 - 10.20）、术前使用苯二氮䓬类药物（比值比，4.61；95%置信区间，2.48 - 8.57）、术中估计失血量超过1000毫升（比值比，2.74；95%置信区间，1.50 - 4.98）以及术中使用氯胺酮（比值比，3.84；95%置信区间，2.21 - 6.68）。此外，发现术后谵妄会显著延长在麻醉后护理单元（PACU）的停留时间和住院时间（p值 < 0.05）。75岁及以上的患者、ASA - PS为IV级的患者、日常生活活动严重功能障碍的患者、术前使用苯二氮䓬类药物的患者、术中估计失血量超过1000毫升的患者以及术中使用氯胺酮的患者被确定为术后谵妄的风险因素。
