JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE) ›› 2022, Vol. 42 ›› Issue (1): 21-27.doi: 10.3969/j.issn.1674-8115.2022.01.004

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Relationship between preoperative glycosylated hemoglobin and postoperative delirium in patients following off-pump coronary artery bypass grafting

Ye HE1,2(), Fang FANG3()   

  1. 1.Shanghai Jiao Tong University School of Nursing, Shanghai 200025, China
    2.Operating Room, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
    3.Department of Nursing, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
  • Received:2021-08-20 Online:2022-01-28 Published:2022-02-18
  • Contact: Fang FANG;
  • Supported by:
    Shanghai Jiao Tong University School of Medicine:Nursing Development Program

Abstract: Objective

·To investigate the relationship between postoperative delirium and preoperative HbA1c in patients with off-pump coronary artery bypass grafting (OPCAB), so as to provide reference for further intervention.


·A prospective study was used to collect 364 surgical patients admitted to the Department of Cardiac Surgery in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. The data were collected through the general information questionnaire and the simple mental status assessment scale, and the Confusion Assessment Method of Intensive Care Unit, and Chinese Version of 3-minute Diagnostic Confusion Assessment Method were used to assess postoperative delirium. Univariate analysis was used to screen out the risk factors for delirium with P<0.05, and then a multi-factor Logistic regression analysis was used. The generalized additive model was used to observe the dynamic changes of HbA1c and the incidence of postoperative delirium, and the receiver operating characteristic (ROC) curve was drawn to clarify the boundary value.


·The influencing factors of postoperative delirium in OPCAB patients were age, alcohol use, peripheral vascular disease, NYHA function classification, LVEF, albumin, HbA1c, intraoperative blood transfusion, acid-base imbalance, and electrolyte imbalance. The generalized additive model and multivariate Logistic regression analysis showed that the higher the preoperative HbA1c, the higher the incidence of postoperative delirium in OPCAB patients.Through ROC curve analysis, it was determined that when the HbA1c>6.45%, the risk of delirium after OPCAB increased accordingly.


·For patients undergoing OPCAB surgery, HbA1c is an independent risk factor for postoperative delirium. With the increase of HbA1c, the incidence of delirium gradually increases, suggesting that the preoperative HbA1c of OPCAB patients should be maintained at a normal level.

Key words: off-pump coronary artery bypass surgery (OPCAB), postoperative delirium, influencing factors, HbA1c, receiver operating characteristic curve

CLC Number: