A nomogram model for assessing predictors and prognosis of postoperative delirium in patients receiving acute type A aortic dissection surgery
Abstract Background Postoperative delirium (POD) complicates the postoperative course. There is limited information on POD-related risk factors (RFs) and prognosis in patients with acute type A aortic dissection (ATAAD) after modified triple-branched stent graft implantation (MTBSG) surgery. Methods...
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| Format: | Article |
| Language: | English |
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BMC
2023-02-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-023-03111-3 |
| _version_ | 1811166081156382720 |
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| author | Jian-Ling Lin Guo-Zhong Zheng Liang-Wan Chen Zeng-Rong Luo |
| author_facet | Jian-Ling Lin Guo-Zhong Zheng Liang-Wan Chen Zeng-Rong Luo |
| author_sort | Jian-Ling Lin |
| collection | DOAJ |
| description | Abstract Background Postoperative delirium (POD) complicates the postoperative course. There is limited information on POD-related risk factors (RFs) and prognosis in patients with acute type A aortic dissection (ATAAD) after modified triple-branched stent graft implantation (MTBSG) surgery. Methods We retrospectively examined consecutive ATAAD patients who received MTBSG surgery in our hospital between January 2013 and December 2019. We employed univariate and multivariate analyses to identify stand-alone RFs for POD. A nomogram was next generated to estimate POD occurrence. The primary outcome was the development of POD, and the secondary outcomes were intensive care unit (ICU) and hospital stays, hospitalization costs, and in-hospital and follow-up mortality. Results We selected 692 patients, of whom 220 experienced POD (31.8%). Based on our analysis, the following factors enhanced the likelihood of POD development: alcohol consumption (p < 0.001), acute physiology and chronic health evaluation II score (p = 0.023), serum total bilirubin (p = 0.007), stage 3 acute kidney injury (p < 0.001), serum interleukin-6 (p = 0.031), post-operative analgesics usage (p = 0.015), and ventilation duration (p = 0.008). POD patients had significantly longer ventilator times (p = 0.003), ICU stays (p < 0.001), and hospital stays (p = 0.038), together with increased hospitalization costs (p < 0.001) and in-hospital mortality (p = 0.019). However, POD was not a RF for mortality during follow-up (log-rank p = 0.611). Conclusions We demonstrated a strong link between POD and poor prognosis in ATAAD patients. We also constructed a prognosis estimator model which will benefit early management guidance to minimize the incidence of POD. |
| first_indexed | 2024-04-10T15:46:45Z |
| format | Article |
| id | doaj.art-bf40153a4c9a4788816c1f8d883c9dfe |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-04-10T15:46:45Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-bf40153a4c9a4788816c1f8d883c9dfe2023-02-12T12:03:57ZengBMCBMC Cardiovascular Disorders1471-22612023-02-0123111310.1186/s12872-023-03111-3A nomogram model for assessing predictors and prognosis of postoperative delirium in patients receiving acute type A aortic dissection surgeryJian-Ling Lin0Guo-Zhong Zheng1Liang-Wan Chen2Zeng-Rong Luo3Department of Cardiovascular Surgery and Cardiac Disease Center, Union Hospital, Fujian Medical UniversityDepartment of Cardiovascular Surgery and Cardiac Disease Center, Union Hospital, Fujian Medical UniversityDepartment of Cardiovascular Surgery and Cardiac Disease Center, Union Hospital, Fujian Medical UniversityDepartment of Cardiovascular Surgery and Cardiac Disease Center, Union Hospital, Fujian Medical UniversityAbstract Background Postoperative delirium (POD) complicates the postoperative course. There is limited information on POD-related risk factors (RFs) and prognosis in patients with acute type A aortic dissection (ATAAD) after modified triple-branched stent graft implantation (MTBSG) surgery. Methods We retrospectively examined consecutive ATAAD patients who received MTBSG surgery in our hospital between January 2013 and December 2019. We employed univariate and multivariate analyses to identify stand-alone RFs for POD. A nomogram was next generated to estimate POD occurrence. The primary outcome was the development of POD, and the secondary outcomes were intensive care unit (ICU) and hospital stays, hospitalization costs, and in-hospital and follow-up mortality. Results We selected 692 patients, of whom 220 experienced POD (31.8%). Based on our analysis, the following factors enhanced the likelihood of POD development: alcohol consumption (p < 0.001), acute physiology and chronic health evaluation II score (p = 0.023), serum total bilirubin (p = 0.007), stage 3 acute kidney injury (p < 0.001), serum interleukin-6 (p = 0.031), post-operative analgesics usage (p = 0.015), and ventilation duration (p = 0.008). POD patients had significantly longer ventilator times (p = 0.003), ICU stays (p < 0.001), and hospital stays (p = 0.038), together with increased hospitalization costs (p < 0.001) and in-hospital mortality (p = 0.019). However, POD was not a RF for mortality during follow-up (log-rank p = 0.611). Conclusions We demonstrated a strong link between POD and poor prognosis in ATAAD patients. We also constructed a prognosis estimator model which will benefit early management guidance to minimize the incidence of POD.https://doi.org/10.1186/s12872-023-03111-3Acute type A aortic dissectionPostoperative deliriumRisk factorsOutcomesNomogram |
| spellingShingle | Jian-Ling Lin Guo-Zhong Zheng Liang-Wan Chen Zeng-Rong Luo A nomogram model for assessing predictors and prognosis of postoperative delirium in patients receiving acute type A aortic dissection surgery BMC Cardiovascular Disorders Acute type A aortic dissection Postoperative delirium Risk factors Outcomes Nomogram |
| title | A nomogram model for assessing predictors and prognosis of postoperative delirium in patients receiving acute type A aortic dissection surgery |
| title_full | A nomogram model for assessing predictors and prognosis of postoperative delirium in patients receiving acute type A aortic dissection surgery |
| title_fullStr | A nomogram model for assessing predictors and prognosis of postoperative delirium in patients receiving acute type A aortic dissection surgery |
| title_full_unstemmed | A nomogram model for assessing predictors and prognosis of postoperative delirium in patients receiving acute type A aortic dissection surgery |
| title_short | A nomogram model for assessing predictors and prognosis of postoperative delirium in patients receiving acute type A aortic dissection surgery |
| title_sort | nomogram model for assessing predictors and prognosis of postoperative delirium in patients receiving acute type a aortic dissection surgery |
| topic | Acute type A aortic dissection Postoperative delirium Risk factors Outcomes Nomogram |
| url | https://doi.org/10.1186/s12872-023-03111-3 |
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