Impact of malnutrition on postoperative delirium development after on pump coronary artery bypass grafting.
Impact of malnutrition on postoperative delirium development after on pump coronary artery bypass grafting.
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DOI：
10.1186/s13019-015-0278-x
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发表时间：
2015-05-20
影响因子：
1.6
通讯作者：
Kačergius T
中科院分区：
文献类型：
--
作者：
Ringaitienė D;Gineitytė D;Vicka V;Žvirblis T;Šipylaitė J;Irnius A;Ivaškevičius J;Kačergius T
尽管在心脏病患者中经常观察到营养不良，但营养不良患者心脏手术后的结局数据非常罕见。关于营养不良对心脏手术后神经心理结局的影响，没有进行过深入的研究。本研究旨在分析接受体外循环旁路移植术的营养不良患者术后谵妄的发生率。我们对维尔纽斯大学医院Santariskiu诊所接受择期冠状动脉旁路移植术的成年人进行了一项队列研究。术前一天采用营养风险筛查2002（NRS-2002）问卷评估患者的营养状况。当NRS-2002评分小于3分时，认为患者没有营养不良的风险，当NRS-2002评分≥3分时，认为患者有营养不良的风险。在ICU住院期间，使用CAM-ICU方法对患者进行术后谵妄发展筛查。分为谵妄和非谵妄两组。对两个独立组之间的差异进行统计学分析。采用Logistic回归模型分析术前和术中术后谵妄的潜在危险因素。99例患者入组研究。24%（n = 24）的患者存在术前营养不良风险。总体研究人群中术后早期谵妄的发生率为8.0%（n = 8）。谵妄组营养不良危险发生率明显高于谵妄组（5例（62.5%）vs 19例（20.9%），P <0.0191）。在多因素Logistic回归分析中，NRS 2002定义的营养不良风险是冠状动脉旁路移植术后谵妄的独立术前和术中危险因素（OR：6.316，95%CI：1.384-28.819 p = 0.0173）。术前营养不良在接受选择性冠状动脉旁路移植术的患者中很常见。非体外循环冠状动脉旁路移植术后营养缺乏与术后早期谵妄相关。
Even though malnutrition is frequently observed in cardiac population outcome data after cardiac surgery in malnourished patients is very rare. No thorough research was done concerning the impact of malnutrition on neuropsychological outcomes after cardiac surgery. The aim of our study was to analyze the incidence of postoperative delirium development in malnourished patients undergoing on pump bypass grafting. We performed a cohort study of adults admitted to Vilnius University Hospital Santariskiu Clinics for elective coronary artery bypass grafting. The nutritional status of the patients was assessed by Nutritional Risk Screening 2002 (NRS-2002) questionnaire the day before surgery. Patients were considered as having no risk of malnutrition when NRS-2002 score was less than 3 and at risk of malnutrition when NRS-2002 score was ≥3. During ICU stay patients were screened for postoperative delirium development using the CAM-ICU method. and divided into two groups: delirium and non delirium. The statistical analysis was preformed to evaluate the differences between the two independent groups. The logistic regression model was used to evaluate the potential preoperative and intraoperative risk factors of postoperative delirium. Ninety-nine patients were enrolled in the study. Preoperative risk of malnutrition was detected in 24 % (n = 24) of the patients. The incidence of early postoperative delirium in overall study population was 8.0 % (n = 8). The incidence of the patients at risk of malnutrition was significantly higher in the delirium group (5 (62.5 %) vs 19 (20.9 %), p <0.0191). In multivariate logistic regression analysis risk of malnutrition defined by NRS 2002 was an independent preoperative and intraoperative risk factor of postoperative delirium after coronary artery bypass grafting (OR: 6.316, 95 % CI: 1.384-28.819 p = 0.0173). Preoperative malnutrition is common in patients undergoing elective coronary artery bypass grafting. Nutrition deprivation is associated with early postoperative delirium after on pump coronary artery bypass grafting.
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影响因子：
1.2
作者：
Al-Sarraf, Nael;Raza, Adnan;McGovern, Eillish
通讯作者：
McGovern, Eillish
影响因子：
6.3
作者：
Anker, S. D.;Laviano, A.;Schols, A. M. W. J.
通讯作者：
Schols, A. M. W. J.
影响因子：
2.5
作者：
DiMaria-Ghalili, Rose Ann
通讯作者：
DiMaria-Ghalili, Rose Ann
影响因子：
7.1
作者：
van Venrooij, Lenny M. W.;de Vos, Rien;de Mol, Bas A. J. M.
通讯作者：
de Mol, Bas A. J. M.
影响因子：
--
作者：
Braga, M;Gianotti, L;Di Carlo, V
通讯作者：
Di Carlo, V