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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Effect of Sleep Disorder on Delirium in Post-Cardiac Surgery Patients
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Effect of Sleep Disorder on Delirium in Post-Cardiac Surgery Patients

机译：睡眠障碍对心脏病后手术患者谵妄的影响

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摘要

Background: Post-cardiac surgery patients exhibit a higher incidence of postoperative delirium (PD) compared to non-cardiac surgery patients. Patients with various cardiac diseases suffer from preoperative sleep disorder (SPD) induced by anxiety, depression, breathing disorder, or other factors. Objective: To examine the effect of sleep disorder on delirium in post-cardiac surgery patients. Methods: We prospectively selected 186 patients undergoing selective cardiac valve surgery. Preoperative sleep quality and cognitive function of all eligible participants were assessed through the Pittsburgh Sleep Quality Index (PSQI) and the Montreal Cognitive Assessment, respectively. The Confusion Assessment Method for Intensive Care Unit was used to assess PD from the first to seventh day postoperatively. Patients were divided into two groups according to the PD diagnosis: (1) No PD group and (2) the PD group. Results: Of 186 eligible patients, 29 (15.6%) were diagnosed with PD. A univariate analysis showed that gender (p = 0.040), age (p = 0.009), SPD (p = 0.008), intraoperative infusion volume (p = 0.034), postoperative intubation time (p = 0.001), and intensive care unit stay time (p = 0.009) were associated with PD. A multivariate logistic regression analysis demonstrated that age (odds ratio (OR): 1.106; p = 0.001) and SPD (OR: 3.223; p = 0.047) were independently associated with PD. A receiver operating characteristic curve demonstrated that preoperative PSQI was predictive of PD (area under curve: 0.706; 95% confidence interval: 0.595-0.816). A binomial logistic regression analysis showed that there was a significant association between preoperative 6 and 21 PSQI scores and PD incidence (p = 0.009). Conclusions: Preoperative SPD was significantly associated with PD and a main predictor of PD.
机译：背景：与非心脏手术患者相比，心脏手术后患者术后谵妄（PD）的发生率较高。患有各种心脏病的患者在术前会因焦虑、抑郁、呼吸障碍或其他因素而出现睡眠障碍（SPD）。目的：探讨睡眠障碍对心脏手术后患者谵妄的影响。方法：我们前瞻性选择186例接受选择性心脏瓣膜手术的患者。所有合格参与者的术前睡眠质量和认知功能分别通过匹兹堡睡眠质量指数（PSQI）和蒙特利尔认知评估进行评估。从术后第1天到第7天，采用重症监护室混乱评估方法评估PD。根据帕金森病的诊断，将患者分为两组：（1）无帕金森病组和（2）帕金森病组。结果：186例符合条件的患者中，29例（15.6%）被诊断为PD。单变量分析显示，性别（p=0.040）、年龄（p=0.009）、SPD（p=0.008）、术中输注量（p=0.034）、术后插管时间（p=0.001）和重症监护病房住院时间（p=0.009）与PD相关。多元逻辑回归分析显示年龄（优势比）为1.106；p=0.001）和SPD（OR:3.223；p=0.047）与PD独立相关。受试者操作特征曲线显示术前PSQI可预测PD（曲线下面积：0.706；95%可信区间：0.595-0.816）。二项logistic回归分析显示，术前6分和21分PSQI评分与PD发病率之间存在显著相关性（p=0.009）。结论：术前SPD与PD显著相关，是PD的主要预测因子。

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