Predicting delirium after vascular surgery -: A model based on pre- and intraoperative data
Predicting delirium after vascular surgery -: A model based on pre- and intraoperative data
复制标题
DOI：
10.1097/00000658-200307000-00019
复制
发表时间：
2003-07-01
影响因子：
9
通讯作者：
Schneider, F
中科院分区：
文献类型：
--
作者：
Böhner, H;Hummel, TC;Schneider, F
目的：本研究的目的是确定接受主动脉、颈动脉和外周血管手术的患者发生术后谵妄的术前和术中危险因素，以预测术后谵妄的风险。虽然血管手术后谵妄是一种常见的并发症，并与需要更多的住院治疗和更长的住院时间有关，对血管外科手术患者谵妄的危险因素知之甚少。方法：前瞻性收集术前、术中和术后数据，包括术后前7天，由外科医生和精神科医生对153例择期血管外科手术患者进行每日随访。精神科医生诊断为谵妄（精神障碍诊断和统计手册IV）。多元线性Logistic回归和交叉验证分析，找到一组参数来预测术后delivery.Results：60例（39.2%）发生术后谵妄。最佳预测因素包括无主动脉上闭塞性疾病和高胆固醇血症、大截肢史、年龄超过65岁、身高小于170 cm、术前精神参数和术中参数与失血量增加相关。这些参数的组合允许估计个体患者在血管手术结束时已经发生术后谵妄的风险，总体准确率为69.9%。结论：血管手术后谵妄是一种常见的并发症。基于术前和术中躯体和精神危险因素的模型可以预测患者术后发生谵妄的风险。
Objective: The aim of the study was to determine pre- and intraoperative risk factors for the development of postoperative delirium among patients undergoing aortic, carotid, and peripheral vascular surgery to predict the risk for postoperative delirium.Summary Background Data: Although postoperative delirium after vascular surgery is a frequent complication and is associated with the need for more inpatient hospital care and longer length of hospital stay, little is known about risk factors for delirium in patients undergoing vascular surgery.Methods: Pre-, intra-, and postoperative data were prospectively collected, including the first 7 postoperative days with daily follow-up by a surgeon and a psychiatrist of 153 patients undergoing elective vascular surgery. Delirium (Diagnostic and statistical Manual of Mental Disorders IV) was diagnosed by the psychiatrist. Multivariate linear logistic regression and a cross validation analysis were performed to find a set of parameters to predict postoperative delirium.Results: Sixty patients (39.2%) developed postoperative delirium. The best set of predictors included the absence of supraaortic occlusive disease and hypercholesterinemia, history of a major amputation, age over 65 years, a body size of less than 170 cm, preoperative psychiatric parameters and intraoperative parameters correlated to increased blood loss. The combination of these parameters allows the estimation of an individual patients' risk for postoperative delirium already at the end of vascular surgery with an overall accuracy of 69.9%.Conclusions: Postoperative delirium after vascular surgery is a frequent complication. A model based on pre- and intraoperative somatic and psychiatric risk factors allows prediction of the patient's risk for developing postoperative delirium.