心脏移植术后患者发生谵妄的影响因素

Influencing factors of delirium in patients after cardiac transplantation

目的:分析心脏移植术后患者发生谵妄的影响因素。方法:回顾性分析2021年1月至2022年12月该院收治的112例心脏移植患者的临床资料,统计心脏移植术后患者谵妄发生情况,采用Logistic回归分析心脏移植术后患者发生谵妄的影响因素。结果:112例心脏移植患者术后发生谵妄18例,发生率为16.07%(18/112),设为发生组,其余设为未发生组;发生组年龄≥65岁、文化程度初中及以下、合并糖尿病、合并高血压、病程≥10年、机械通气时间≥24 h、术后输血、术前焦虑或抑郁、术后抗排斥药物使用占比均高于未发生组,差异有统计学意义(P<0.05);Logistic回归分析结果显示,年龄≥65岁、文化程度初中及以下、合并糖尿病、合并高血压、病程≥10年、机械通气时间≥24 h、术后输血、术前焦虑或抑郁、术后抗排斥药物使用等均为影响心脏移植术后患者发生谵妄的危险因素(OR>1,P<0.05)。结论:年龄≥65岁、文化程度初中及以下、合并糖尿病、合并高血压、病程≥10年、机械通气时间≥24 h、术后输血、术前焦虑或抑郁、术后抗排斥药物使用均为影响心脏移植术后患者发生谵妄的危险因素。

Objective:To analyze influencing factors of delirium in patients after cardiac transplantation.Methods:The clinical data of 112 patients with cardiac transplantation admitted to this hospital from January 2021 to December 2022 were retrospectively analyzed.The incidence of delirium in these patients after cardiac transplantation was statistically analyzed.Logistic regression was used to analyze the influencing factors of delirium in the patients after cardiac transplantation.Results:Among the 112 cardiac transplantation patients,18 experienced delirium after the surgeries with an incidence rate of 16.07%(18/112),and they were assigned to the occurrence group,while the rest were assigned to the non-occurrence group.The proportions of the patients with age≥65 years old,junior high school education level and below,combined diabetes mellitus,combined hypertension,course of disease≥10 years,mechanical ventilation time≥24 h,postoperative blood transfusion,preoperative anxiety or depression,and postoperative anti-rejection drug use in the occurrence group were higher than those in the non-occurrence group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that age≥65 years,junior high school education level and below,combined diabetes mellitus,combined hypertension,course of disease≥10 years,mechanical ventilation time≥24 h,postoperative blood transfusion,preoperative anxiety or depression,and postoperative anti-rejection drug use were all risk factors affecting delirium in the patients after cardiac transplantation(OR>1,P<0.05).Conclusions:Age≥65 years,junior high school education level and below,combined diabetes mellitus,combined hypertension,course of disease≥10 years,mechanical ventilation time≥24 h,postoperative blood transfusion,preoperative anxiety or depression,and postoperative anti-rejection drug use are the risk factors affecting delirium in the patients after cardiac transplantation.