Journal of Shanghai Jiao Tong University (Medical Science) >

2021 , Vol. 41 >Issue 12: 1580 - 1586

DOI: https://doi.org/10.3969/j.issn.1674-8115.2021.12.006

Characteristics and influencing factors of postoperative delirium among elderly patients in intensive care unit

  • Zhi-shan WU ,
  • Run HUANG ,
  • Li-ping LIANG ,
  • Yu-ting ZHU ,
  • Qiao-mu ZHENG ,
  • Li-ping JIANG
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  • 1.Shanghai Jiao Tong University School of Nursing, Shanghai 200025, China
    2.Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
    3.Department of Geriatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
    4.Department of Nursing, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
JIANG Li-ping, E-mail: 13868311990@163.com.

Received date: 2020-12-18

  Online published: 2021-01-28

Supported by

Shanghai Jiao Tong University Nursing Discipline Construction Project(Hlgy1801sjk)

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Abstract

Objective

·To investigate the characteristics and influencing factors of postoperative delirium among elderly patients admitted to intensive care unit (ICU).

Methods

·The convenience sampling method was used to select cardiothoracic surgical ICU patients after operation in Xinhua Hospital, Shanghai Jiao Tong University School of Medicine from May to September 2020. Delirium was assessed using the Confusion Assessment Method-ICU (CAM-ICU) and the assessment was performed until ICU discharge or for a maximum of 7 d, whichever occurred first. Patients′ demographics and clinical data were collected. The influencing factors were analyzed by univariate analysis and multivariate Logistic regression.

Results

·A total of 343 patients were included for this study and 103 developed postoperative delirium, with an incidence of 30.03%. All the delirium occurred within 7.5?130.0 h after operation, with a mean of (47.4±29.7) h and a median of 35.5(23.0, 61.0) h. On the whole, delirium uniformly distributed throughout the day. Only the delirium that occurred within 24 h after surgery showed a central tendency with the high-incidence time at 11:53 am while the others did not. Delirium duration lasted 6.5?131.0 h, with a mean of (32.4±28.1) h and a median of 20.5(14.0, 45.0) h. Comparison of the characteristics of patients in the delirium group and non-delirium group showed that there were statistical differences in gender, history of diabetes, heart function classification, American Society of Anesthesiologists (ASA) classification, operation duration, intraoperative blood loss, intraoperative cardiopulmonary bypass, intraoperative hypotension, postoperative mechanical ventilation and postoperative oxygenation index. Multivariate Logistic regression analysis showed that ASA classification, intraoperative hypotension and cardiopulmonary bypass had significant influence on postoperative delirium (all P<0.05).

Conclusion

·The incidence of postoperative delirium is high among elderly patients who are admitted in ICU after operation. Higher ASA classification, intraoperative hypotension and cardiopulmonary bypass are influencing factors of delirium. To reduce delirium occurrence and shorten its duration, medical staff should understand the characteristics and influencing factors of postoperative delirium, evaluate delirium and implement preventive interventions.

Key words： postoperative delirium; intensive care unit (ICU); the aged; characteristic analysis; influencing factor

Cite this article

Zhi-shan WU , Run HUANG , Li-ping LIANG , Yu-ting ZHU , Qiao-mu ZHENG , Li-ping JIANG . Characteristics and influencing factors of postoperative delirium among elderly patients in intensive care unit[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2021 , 41(12) : 1580 -1586 . DOI: 10.3969/j.issn.1674-8115.2021.12.006

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