Analysis Of The Incidence And Risk Factors Of Delirium In ICU After Coronary Artery Bypass Grafting

Objective: Delirium occurring in ICU is called ICU delirium,which has a high incidence and seriously affects the prognosis of patients.The purpose of this study is to investigate and analyze the perioperative risk factors and occurrence of ICU delirium after coronary artery bypass grafting,so as to provide theoretical basis for reducing the occurrence of postoperative ICU delirium and improving the prognosis of patients.Methods: From January 2017 to December 2019,371 patients who underwent coronary artery bypass grafting in the Department of Cardiology,First Affiliated Hospital of Xinjiang Medical University and were transferred to ICU after operation were selected as the research objects.The CAM-ICU scale was used as a tool to judge ICU delirium.According to whether ICU delirium occurred,the research objects were divided into ICU delirium group and non-ICU delirium group.At the same time,the perioperative clinical data of the two groups were collected,including basic data such as gender,ethnicity,age,body mass index,etc.The perioperative indicators include,Blood routine(red blood cell count,platelet count,hemoglobin,etc.),blood gas analysis(Ph value,lactic acid value,sodium ion concentration,potassium ion concentration,etc.),coagulation function(activated partial prothrombin time,prothrombin time,fibrinogen),liver function(aspartate aminotransferase,alanine aminotransferase,albumin),kidney function(blood creatinine,urea nitrogen),procalcitonin,high sensitivity C.To analyze the relationship between related factors and the occurrence of delirium in ICU.Results: Of the 371 patients,141(38%)were in delirium group and 62%(62%)were in non-ICU delirium group.The baseline data between ICU delirium group and non-ICU delirium group showed no statistical difference in gender,weight,BMI,nationality,basic causes(hypertension,diabetes,depression),smoking history and drinking history(P>0.05),but there were significant differences in age,arrhythmia,stroke history and total hospitalization expenses.Univariate analysis showed that the operation mode(single or combined,P=0.002),blood loss(P=0.000),BNP(P=0.007),APACHE II score(P=0.014),hemoglobin(Hb,P=0.000),platelet(Plt,P=0.000),interleukin-6(IL-6,P=0.014),serum creatinine(Cr,P=0.008)and cardiopulmonary bypass(CPB,P=0.000)were related to the occurrence of delirium in ICU.Logistic multivariate regression analysis results indicated age(OR value 1.114,95%CI 1.069～1.161),history of stroke(OR value 4.874,95%CI2.127～11.167),and extracorporeal circulation(OR value 5.763,95%CI 2.622～12.666)were related to the occurrence of delirium in ICU.Conclusion: Advanced age,history of stroke,and extracorporeal circulation are independent risk factors for ICU delirium after coronary artery bypass grafting,which should be prevented.