综合ICU严重多发伤患者谵妄发生状况及影响因素分析

Incidence and influencing factors of delirium in severe multiple trauma patients in comprehensive ICU

目的统计综合重症监护室(ICU)严重多发伤患者谵妄的发生状况,并分析影响其发生的相关因素。方法前瞻性研究。抽取2021年12月至2022年12月转入南阳市第一人民医院综合ICU治疗的严重多发伤患者112例作为研究对象,根据其在ICU内是否发生谵妄分为发生组与未发生组,收集患者基线资料并使用单因素、Logistic回归性分析影响综合ICU严重多发伤患者发生谵妄的相关因素。结果112例患者研究结束脱落1例,余111例患者中出现谵妄33例,占29.73%(33/111)。发生组与未发生组年龄、合并低氧血症、合并糖尿病、合并高血压、胰岛素样生长因子-1(IGF-1)水平以及重症监护疼痛观察工具(CPOT)评分比较,差异有统计学意义(P<0.05)。经Logistic回归性分析显示,年龄、合并低氧血症、IGF-1水平、CPOT评分偏高是影响严重多发伤患者出现谵妄的危险因素(P<0.05)。结论综合ICU严重多发伤患者出现谵妄的风险较高,受年龄、低氧血症、IGF-1水平以及CPOT评分影响。

Objective To investigate the incidence of delirium in severe multiple trauma patients in the intensive care unit(ICU),and to analyze the relevant factors that affect its occurrence.Methods A prospective study was conducted on 112 patients with severe multiple trauma who were transferred to the comprehensive ICU in Nanyang First People’s Hospital from December 2021 to December 2022.They were divided into two groups based on whether they experienced delirium in the ICU:the occurrence group and the non occurrence group.The baseline data of patients were collected,and the influencing factors of delirium in patients with severe multiple trauma in comprehensive ICU were analyzed by univariate and logistic regression analyses.Results Among the 112 cases,1 case fell off,and 33 cases of delirium occurred in the remaining 111 patients,accounting for 29.73%(33/111).There were significant differences in age,hypoxemia,diabetes,hypertension,insulin-like growth factor-1(IGF-1)level and critical care pain observation tool(CPOT)score between the occurrence group and the non occurrence group(P<0.05).Results of logistic regression analysis revealed that age,hypoxemia,IGF-1 level and high CPOT score were the risk factors for delirium in patients with severe multiple trauma(P<0.05).Conclusions Patients with severe multiple trauma in comprehensive ICU have a higher risk of delirium,which is affected by age,hypoxemia,IGF-1 level and CPOT score.