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Journal of Nursing ›› 2020, Vol. 27 ›› Issue (1): 56-61.doi: 10.16460/j.issn1008-9969.2020.01.056

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Risk Factors of Postoperative Delirium in Patients in Cardiac Surgery Intensive Care Unit

ZHU Li-huaa, ZHOU Minb, ZHAI Xiao-yuana   

  1. 1. Intensive Care Unit of Dept. of Cardiac Surgery;
    2. Dept. of Intensive Care Unit, Qilu Hospital of Shandong University, Jinan 250012, China
  • Received:2019-07-17 Online:2020-01-10 Published:2020-07-20

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Abstract: Objective To evaluate the incidence of postoperative delirium in patients in cardiac surgery intensive care unit (CSICU), and to analyze the risk factors and the efficiency of each risk factor in predicting postoperative delirium. Methods In this cross-section survey, patients hospitalized in CSICU after cardiac surgery of one tertiary grade A hospital from January to May 2019 were selected as research objects. Confusion Assessment Methodfor the Intensive Care Unit, general information questionnaire, Acute Physiology and Chronic Health Evaluation (APACHEⅡ), Critical-care Pain Observation Tool, Pittsburgh sleep quality index and intensive care unit environmental stressor scale were used to collect the data. Risk factors of postoperative delirium in CSICU patients were analyzed by using single factor analysis and multivariate logistic regression. ROC curve was used to describe the predictive effectiveness of the risk factors and the best threshold. Results Of the 316 patients included, 81 cases of delirium were found, with an incidence of 25.6%. Logistic regression showed that APACHEⅡscore(OR=1.257,95%CI=1.018~1.553), circulatory arrest time more than 15 minutes (OR=6.943, 95%CI=1.288~37.429), average postoperative pain score (OR=2.918, 95%CI=1.749~4.867), sleep quality score (OR=1.147,95%CI=1.038~1.267),and ICU environment pressure source score(OR=1.161,95%CI=1.110~1.214) were independent risk factors of postoperative delirium. ROC curve results showed that the area under the curve of APACHEⅡ,circulatory arrest time longer than 15 minutes, mean score of postoperative pain, sleep quality score and ICU environmental pressure source score were 0.745, 0.617, 0.758, 0.837 and 0.910 respectively, and their optimal cut-off value was 9, 3, 14 and 72 respectively. Conclusion The incidence of postoperative delirium CSICU patients is high. Postoperative delirium is more likely to occur in patients with APACHEⅡscore>9, circulatory arrest time longer than 15min, mean score of postoperative pain>3, score of sleep quality>14,and score of ICU environment pressure source>72 are risk factors of postoperative delirium. This study provides reference for improving the management of postoperative delirium in CSICU patients.

Key words: cardiac surgical intensive care unit, postoperative delirium, risk factor, ROC curve

CLC Number: 

  • R473.54
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