A Nomogram Model for Assessing Predictors and Prognosis of Postoperative Delirium in Patients Receiving Acute Type A Aortic Dissection Surgery

Overview

Journal BMC Cardiovasc Disord

Publisher Biomed Central

Specialty Cardiology & Vascular Diseases

Date 2023 Feb 8

PMID 36750929

Authors

Jian-Ling Lin

Guo-Zhong Zheng

Liang-Wan Chen

Zeng-Rong Luo

Affiliations

Soon will be listed here.

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.

Citing Articles

Practical prognostic tools to predict the risk of postoperative delirium in older patients undergoing cardiac surgery: visual and dynamic nomograms.

Bah C, Mbambara B, Xie X, Li J, Iddi A, Chen C J Clin Monit Comput. 2024; 39(1):11-24.

PMID: 39305450 DOI: 10.1007/s10877-024-01219-1.

A nomogram-based model to predict postoperative transient neurological dysfunctions in patients receiving acute type A aortic dissection surgery.

Lin X, Xie L, He J, Xie Y, Zhang Z, Chen L J Clin Hypertens (Greenwich). 2023; 25(12):1193-1201.

PMID: 37964741 PMC: 10710554. DOI: 10.1111/jch.14744.

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