心脏瓣膜术后患者不同谵妄亚型发生情况及相关因素研究

doi:10.3969/j.issn.1006-6233.2025.05.023

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Abstract Objective: To analyze the occurrence and related factors of different delirium subtypes in patients after cardiac valve surgery. Methods: Totally 103 patients who received cardiac valve surgery in the hospital from January 2021 to January 2024 were enrolled as the study subjects. Richmond Agitation-Sedation Score (RASS) and Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) were adopted to evaluate the occurrence and subtypes of delirium on the 2nd day after surgery. According to the occurrence of postoperative delirium, the patients were divided into delirium group and non-delirium group. The clinical data of all patients were collected, and the influencing factors of delirium after cardiac valve surgery were analyzed by univariate analysis and multivariate Logistic regression analysis. Results: In this study, 31 cases of delirium occurred in 103 patients with cardiac valve surgery, with an incidence of 30.10%. Among the 31 cases, there were 15 cases of low-activity delirium [48.39% (15/31)], 6 cases of high-activity delirium [19.35% (6/31)] and 10 cases of mixed delirium [32.26% (10/31)]. Univariate analysis indicated that there were statistical differences in age, mechanical ventilation time, acute physiology and chronic health evaluation II (APACHE II) score, cardiopulmonary bypass time, concurrent anemia, atrial fibrillation, ICU stay and surgical time between groups (P<0.05). Logistic regression analysis found that age≥70 (OR=1.642, 95%CI: 1.030~2.618), mechanical ventilation duration≥6 h (OR=3.568, 95%CI: 2.037~6.250), APACHEⅡ score≥10 points (OR=2.683, 95%CI: 1.447~4.975), cardiopulmonary bypass time≥2 h (OR=2.166, 95%CI: 1.317~3.564), concurrent anemia (OR=2.971, 95%CI: 1.723~5.124), atrial fibrillation (OR=1.459, 95%CI: 1.014~2.101), ICU stay≥36 h (OR=2.401, 95%CI: 1.423~4.052), and surgical time≥5 h (OR=2.030, 95%CI: 1.271~3.243) were high risk factors for delirium after cardiac valve surgery (P<0.05). Conclusion: Patients after cardiac valve surgery have a high risk of delirium, and low-activity delirium is the main subtype. The age of patients, mechanical ventilation time, APACHE II score, cardiopulmonary bypass time, concurrent anemia, atrial fibrillation, ICU stay and surgical time are the main factors affecting the occurrence of delirium in postoperative patients. Clinically, it is necessary to actively screen the above factors and take targeted prevention and control measures to reduce the risk of delirium.

Key words： Cardiac valve disease Delirium Subtypes Risk factors

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	ZHENG Xiong
	WANG Weiqiang
	LIU Lei

Cite this article:

ZHENG Xiong,WANG Weiqiang,LIU Lei. Study on Occurrence and Related Factors of Different Subtypes of Delirium in Patients after Cardiac Valve Surgery[J]. HeBei Med, 2025, 31(5): 832-838.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2025.05.023 OR http://www.hbyxzzs.cn/EN/Y2025/V31/I5/832

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