老年患者PCI术后谵妄的回顾性分析

Retrospective analysis of postoperative delirium in elder patients after percutaneous coronary intervention.

目的研究老年患者经皮冠状动脉介入治疗（Percutaneous coronary intervention，PCI）后谵妄的发生率、临床特点及相关危险因素。方法305例PCI术后患者，32例发生术后谵妄，将其设为谵妄组，随机抽取32例无谵妄症状PCI术后患者作为对照组，采用Logistic回归分析法分析诱发谵妄的危险因素。结果32例（10．5％）患者在手术后6d内发生谵妄。多因素回归分析显示具有统计学意义的相关因素有既往脑血管病史（OR=15．129；9s％CI2．355～97．183）、房颤病史（OR=32．355；95％CI4．330～241．746）及低LVEF值（OR=3．409；95％C10．668～17．393）。结论老年PCI术后患者谵妄发生率较高，既往脑血管病史、房颤病史及低LvEF值是PCI术后谵妄的高危因素。

Objective To investigate the incidence and manifestation of delirium in elder after percutaneous coronary intervention and identify its possible risk factors. Methods Three hundred and five consecutive patients who unde went PCI were enrolled in the study. Risk factors for inducing delirium were analyzed in patients with delirium（n= 32 ） and without delirium（n= 32） by Logistic regression analysis. Results Postoperative delirium was detected in 32 （10.5 %） patients during the first 6 days after surgery. According to multivariate analysis, significant risk factors for the development of postoperative delirium were cerebrovascular history[odds ratio（OR） = 15. 129,95 % CI 2. 355 97. 183], atrial fibrillation history （ OR = 32. 355,95 % CI 4. 330 - 241. 746 ） and low LVEF （ OR = 3. 409,95 % CI 0. 668-17. 393}. Conclusions The incidence of postoperative delirium in elder after PCI is high. Risk factors like cerebrovascular history,atrial fibrillation history and low LVEF are associated with postoperative delirium in elder af- ter PCI.