Incidence And Risk Factors Of Delirium After Brain Tumor Surgery

Objective:Analyze and discuss the risk factors and preventive measures of postoperative delirium(POD)in patients with brain tumors.Methods:According to the California Assessment Manual(CAM),the brain tumor patients who underwent surgery in our department from January 2019 to December 2019 were divided into POD group and non-POD group,collected relevant clinical data.Single-factor and multi-factor Logistic regression were used to analyze the risk factors of POD,and the prevention and treatment strategies were discussed.Results:A total of 399 patients were enrolled in this study,including36 patients with postoperative delirium(POD group),and the remaining363 patients were included in the non-POD group.Compared with the non-POD group,patients in the POD group were older(t=3.040,P=0.004),the BI index was lower(X~2=18.061,P<0.001),and more smoking history(X~2=5.478,P=0.019),longer operation time(X~2=18.310,P<0.001),more intraoperative blood loss(Z=-3.110,P=0.002),longer ICU stay and total length of stay(X~2=33.862,P<0.001;U=-6.163,P<0.001),More protective restraints were used(X~2=56.000,P<0.001),and GCS score on the first day after surgery and GOS score at discharge are lower(Z=-7.351,P<0.001;X~2=29.450,P<0.001).Logistic multiple regression analysis showed:BI index(OR=2.71,95%CI 1.051～7.024,P<0.001),Operation time is more than 4 hours(OR=1.078,95%CI 1.019～1.321,P<0.001),use of protective restraints(OR=13.576,95%CI 5.049～36.505,P<0.001),GCS score(OR=1.631,95%CI 1.631～1.859,P<0.001)on the first day after surgery is the POD of brain tumor patients Independent risk factors.Conclusion:POD is one of the common complications of brain tumor patients after surgery.It is more common in the elderly.Reduced ability of daily living,operation time greater than 4 hours,use of protective restraints,and decreased GCS scores on the first day after surgery will all increase the incidence of POD.Strictly following the principles of minimally invasive surgery,reducing operative injuries,shortening the length of surgery and IUC hospital stay,and reducing the use of protective restraints can reduce the occurrence of POD.