Preliminary Clinical Study Of Delirium After Endovascular Exclusion For Aortic Dissection

ObjectiveTo probe into the incidence and risk factors of delirium after endovascular exclusion for aortic dissection through a retrospective study, including baseline characteristics and perioperative variables. Evaluate their roles in the occurrence of delirium after endovascular exclusion for aortic dissection and provide relevant prevention and therapy.MethodsIn this retrospective study,66patients who were admitted to the interventional radiology department in the first affiliated hospital of Zhengzhou University from January2010to December2012were enrolled. The case group was consisted of16patients who developed into delirium, and the others were enrolled in the control group. Blood samples were obtained on preoperative and the first postoperative day. Hypersensitive C reactive protein(hs-CRP), erythrocyte sedimentation rate(ESR) and peripheral serum cortisol concentration were measured. Delirium was assessed using the Confusion Assessment Method Chinese Reversion (CAM-CR) if delirious symptoms appeared. Results66cases in total were involved in this research, postoperative delirium occurred in24.2%of patients (16/66). Independent risk factors of postoperative delirium included advanced age (odds ratio (OR)1.069,95%confidence interval (CI)1.007to1.134, P=0.029), high peripheral serum cortisol level on the first postoperative day (OR3.379,95%CI1.590to6.475, P=0.001). Educational level was not the protective factor of postoperative delirium (OR0.560,95%CI0.131to2.398, P=0.434). Sexual distinction(P=0.925), a history of smoking (P=0.839)and drinking(P=0.254), the duration of anesthesia(P=0.721) and surgery(P=0.910), the dosage of iodine contrast agent(P=0.654), the concentration of preoperative hs-CRP(P=0.535), serum cortisol(P=0.316) and ESR(P=0.540,P=0.575) had no statistical discrepancy between the cases and controls.Conclusion(1) Advanced age was the main risk factor of delirium after endovascular exclusion for aortic dissection.(2) High level of stress reaction was also the main risk factor of delirium after endovascular exclusion for aortic dissection, therefore the control of stress reaction is one of effective measures in reducing the occurrence of delirium after endovascular exclusion for aortic dissection.(3) Serum cortisol was maybe a predictor of delirium after endovascular exclusion for aortic dissection.