Assessment of preoperative frailty and identification of patients at risk for postoperative deliriumin cardiac intensive care units: a prospective observational study

被引:15
作者
Cheng, Hsiao-Wei [1 ]
Liu, Chieh-Yu [2 ]
Chen, Yih-Sharng [3 ,4 ]
Shih, Chun-Che [5 ,6 ,7 ,8 ]
Chen, Wei-Yi [9 ]
Chiou, Ai-Fu [10 ]
机构
[1] Natl Taiwan Univ Hosp, Dept Nursing, 7 Chung Shan South Rd, Taipei 100, Taiwan
[2] Natl Taipei Univ Nursing & Hlth Sci, Dept Hlth Care Management, Biostat Consultant Lab, 365 Ming Te Rd, Taipei 112, Taiwan
[3] Natl Taiwan Univ Hosp, Dept Surg Cardiovasc Surg & Ped Cardiovasc Surg, 7 Chung Shan South Rd, Taipei 100, Taiwan
[4] Natl Taiwan Univ, Coll Med, 7 Chung Shan South Rd, Taipei 100, Taiwan
[5] Taipei Med Univ, Taipei Heart Inst, 250 Wu Hsing St, Taipei 110, Taiwan
[6] Taipei Med Univ, Wan Fang Hosp, Dept Surg, Div Cardiovasc Surg, 111,Sect 3,Xinglong Rd, Taipei 116, Taiwan
[7] Taipei Med Univ, Coll Med, Sch Med, Dept Surg, 250 Wu Hsing St, Taipei 110, Taiwan
[8] Natl Yang Ming Chiao Tung Univ, Coll Med, Sch Med, Inst Clin Med,Dept Surg, 155,Sect 2,Li Nong St, Taipei 112, Taiwan
[9] Taipei Vet Gen Hosp, Dept Nursing, 201,Sect 2,Shipai Rd, Taipei 112, Taiwan
[10] Natl Yang Ming Chiao Tung Univ, Coll Nursing, Inst Clin Nursing, 155,Sect 2,Li Nong St, Taipei 112, Taiwan
关键词
Cardiac surgery; Frailty; Delirium; Arrhythmia; Anxiety; Depression; SURGERY; OUTCOMES;
D O I
10.1093/eurjcn/zvab076
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Postoperative delirium (POD) is a common complication that may occur from 24 to 72 h after cardiac surgery. Frailty is a chronic syndrome that leads to a decline in physiological reserve and to disability. The associations between frailty and POD are unclear. Aims To investigate associations between POD and frailty in patients undergoing cardiac surgery and to analyse predictors of POD. Methods and results Convenience sampling was used to recruit 152 patients who underwent cardiac surgery in two medical centres in northern Taiwan. Preoperative frailty in these patients was evaluated using Fried's frailty phenotype. Delirium in patients was assessed from postoperative day 1 to day 5 using the confusion assessment method for intensive care units. A total of 152 patients who underwent cardiac surgery included 68 (44.74%) prefrail patients and 21 (13.81%) patients with frailty after the surgery. Ten patients (6.58%) developed delirium after cardiac surgery. The occurrence of delirium peaked at postoperative day 2, and the average duration of delirium was 3 days. A casecontrol comparison revealed a significant correlation between preoperative frailty and POD. Significant predictors of POD in patients undergoing cardiac surgery included the European System for Cardiac Operative Risk Evaluation II, preoperative arrhythmia, and preoperative anxiety and depression. Conclusion Preoperative frailty was correlated with POD. Preoperative arrhythmia, anxiety, and depression are predictors of POD. Nurses should perform preoperative assessments of surgical risk and physiological and psychological conditions of patients undergoing cardiac surgery and monitor the occurrence of POD.
引用
收藏
页码:745 / 751
页数:7
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