Retrospective Analysis Of Delirium After PCI In Patients With Acute Coronary Syndrome

ObjectiveTo investigate the incidence of delirium in patients with acute coronary syn drome(ACS)after percutaneous coronary intervention(PCI),and to analyze the risk factors of delirium in ACS patients after PCI.Through retrospective analysi s of the risk factors that may affect delirium after PCI,the relative controllable factors are screened out from many factors.Appropriate intervention measures fo r controllable factors in clinical practice are of positive significance for reducing the incidence of delirium and preventing and treating delirium.At the same ti me,it provides a theoretical basis for dealing with delirium in clinical work.MethodsA retrospective analysis was made of the basic data of ACS patients after PCI in the Second Affiliated Hospital of Shenyang Medical College from Janua ry 2013 to December 2017.Two psychiatrists screened patients for delirium bef ore PCI and assessed delirium within one week after PCI.If the two psychiatris ts assessment conclusions were inconsistent,a third psychiatrist assessed delirium.The patients were divided into delirium group and control group according to whether they had delirium within one week after PCI.The basic data of the sel ected patients,such as sex,age,height(cm),weight(kg),diagnosis(unstable ang ina,st-elevation myocardial infarction,non-st-elevation myocardial infarction),pas t history(history of hypertension,diabetes mellitus,atrial fibrillation,etc.),perso nal history(history of smoking and drinking);laboratory indicators:blood routin e,urea,creatinine,ions,and lipid levels(TC,TG),etc.coronary angiography res ults:degree of coronary artery disease(single,double and triple vessels).Record s of PCI operation:duration of PCI(min),types of contrast agents(ioversol,iohe xol,iodixanoI,iopromide)and dose(ml);echocardiography:left ventricular ejection fraction(LVEF).Statistical software was used for statistical analysis.First,univari ate analysis was carried out to find out the risk factors related to delirium after PCI(P<0.05 as the difference was statistically significant).Independent variabl es with statistical significance from univariate analysis were substituted for binar y logistic regression analysis model.Backward stepping(likelihood ratio)was us ed to determine the independent risk factors for delirium after PCI.Calculating t he incidence of delirium after PCI.ResultsA total of 880 patients were enrolled in this study.Fifteen patients develop ed delirium within one week after PCI.The incidence of delirium was about 170%.Among them,6 were female patients and 9 were male patients.Their age ranged from 68 to 88 years,with an average age of 78.40±5.78 years.Among the 15 patients,the shortest onset time was within 1 hour after PCI and the to ngest was 38 hours after PCI.The shortest duration of delirium symptoms was 1 hour(1 case)and the longest was 3 days(1 case).After active support and s ymptomatic treatment,all 15 patients recovered and discharged.Univariate analys is results showed that age,sleep disorder,estimated glomerular filtration rate(e GFR),degree of coronary artery lesion,dosage of contrast agents were significa ntly different between delirium group and control group(P<0.05).Independent v ariables with statistical differences in univariate analysis were substituted for bin ary logistic regression analysis model,and the results showed age(OR=1.216;95%CI:1.109-1.333;p<0.001),sleep disorders(OR=4.043;95%CI:1.030-15870;p=0.045),degree of coronary artery lesions(OR=3.110;95%CI:1.471-6574;p=0.003),dosage of contrast agents(OR?1.023;95%CI:1.010?1.036;P<0.001)were significantly different between the control group and delirium gr oup.Conclusions1.Delirium in ACS patients after PCI is the result of multiple factors.2.The incidence of delirium in ACS patients after PCI is about 1.70%.3.Age,sleep disorder,degree of coronary artery disease and dosage of contr ast agents are independent risk factors for delirium after PCI in ACS patient s.4.The older the age,the worse the sleep,the more complex the coronary 1 esions,the larger the contrast agent,and the greater the risk of delirium.