A nomogram model for assessing predictors and prognosis of postoperative delirium in patients receiving acute type A aortic dissection surgery

BMC Cardiovascular Disorders

Research

Liang-Wan Chen¹  Jian-Ling Lin¹  Guo-Zhong Zheng¹  Zeng-Rong Luo¹ 

[1] Department of Cardiovascular Surgery and Cardiac Disease Center, Union Hospital, Fujian Medical University, 350001, Fuzhou, People’s Republic of China;Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, People’s Republic of China;

关键词: Acute type A aortic dissection;    Postoperative delirium;    Risk factors;    Outcomes;    Nomogram;   

DOI  :  10.1186/s12872-023-03111-3

 received in 2022-10-30, accepted in 2023-02-03,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundPostoperative delirium (POD) complicates the postoperative course. There is limited information on POD-related risk factors (RFs) and prognosis in patients with acute type A aortic dissection (ATAAD) after modified triple-branched stent graft implantation (MTBSG) surgery.MethodsWe retrospectively examined consecutive ATAAD patients who received MTBSG surgery in our hospital between January 2013 and December 2019. We employed univariate and multivariate analyses to identify stand-alone RFs for POD. A nomogram was next generated to estimate POD occurrence. The primary outcome was the development of POD, and the secondary outcomes were intensive care unit (ICU) and hospital stays, hospitalization costs, and in-hospital and follow-up mortality.ResultsWe selected 692 patients, of whom 220 experienced POD (31.8%). Based on our analysis, the following factors enhanced the likelihood of POD development: alcohol consumption (p < 0.001), acute physiology and chronic health evaluation II score (p = 0.023), serum total bilirubin (p = 0.007), stage 3 acute kidney injury (p < 0.001), serum interleukin-6 (p = 0.031), post-operative analgesics usage (p = 0.015), and ventilation duration (p = 0.008). POD patients had significantly longer ventilator times (p = 0.003), ICU stays (p < 0.001), and hospital stays (p = 0.038), together with increased hospitalization costs (p < 0.001) and in-hospital mortality (p = 0.019). However, POD was not a RF for mortality during follow-up (log-rank p = 0.611).ConclusionsWe demonstrated a strong link between POD and poor prognosis in ATAAD patients. We also constructed a prognosis estimator model which will benefit early management guidance to minimize the incidence of POD.

【 授权许可】

CC BY   
© The Author(s) 2023

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