经皮左心耳封堵术术后谵妄的发生率及危险因素:单中心回顾性研究

Incidence and risk factors of postoperative delirium after percutaneous left atrial appendage closure:A single-center retro-spective study

目的探讨行经皮左心耳封堵术患者术后谵妄(postoperative delirium,POD)的发生率及相关危险因素。方法回顾性分析2015年12月至2019年11月解放军总医院第一医学中心收治的180例经皮左心耳封堵术患者的临床资料,根据患者有无发生POD分为谵妄组(17例)与非谵妄组(163例),统计POD发生率,并采用多因素Logistic回归分析评估相关危险因素。结果180例患者中有17例出现POD,发生率为9.44%。单因素分析结果显示,两组患者年龄、年龄≥75岁、高血压史、糖尿病史、术前贫血差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,年龄[比值比(odds ratio,OR)1.211,95%CI 1.036~1.415,P<0.05]、糖尿病史(OR 6.209,95%CI 1.659~23.737,P<0.05)、术前贫血(OR 3.646,95%CI 1.011~13.150,P<0.05)是经皮左心耳封堵术患者发生POD的独立危险因素。结论经皮左心耳封堵术POD有一定的发生率,年龄、糖尿病史、术前贫血是其发生的独立危险因素。

Objective To investigate the incidence and risk factors for postoperative delirium(POD)after percutaneous left atrial appendage closure.Methods A total of 180 patients who underwent percutaneous left atrial appendage closure in the First Medical Center of PLA General Hospital from December 2015 to November 2019 were enrolled and their clinical data were retrospec-tive analyzed.According to the presence of postoperative delirium,the patients were divided into two groups:a delirium group(n=17)and a non-delirium group(n=163).The incidence of postoperative delirium was recorded,while the related risk factors were analyzed by multivariate logistic regression.Results POD occurred in 17 of 180 patients(9.44%).According to univariate analysis,both groups showed statistical differences in age,age≥75 years,history of hypertension,history of diabetes and preoperative anemia indica-tors(P<0.05).Multivariate logistic regression analysis showed that age{odds ratio(OR)1.211[95%confidence interval(CI)1.036,1.415],P<0.05},history of diabetes[OR 6.209(95%CI 1.659,23.737),P<0.05],and preoperative anemia[OR 3.646(95%CI 1.011,13.150),P<0.05]were the independent risk factors for POD in patients undergoing percutaneous left atrial appendage closure.Con-clusions There is a certain incidence of POD after percutaneous left atrial appendage closure.Age,history of diabetes and anemia are the independent risk factors for POD.