Research progress of risk factors and prediction models of postoperative delirium after aortic dissection

doi:10.3761/j.issn.0254-1769.2023.02.007

Abstract

Abstract:

Postoperative delirium is one of the common complications in patients with aortic dissection，with a high incidence and strong harm. In this study，the types，characteristics，risk factors and risk prediction models of delirium after aortic dissection were reviewed，in order to provide references for clinical medical staff to identify the risk of delirium in aortic dissection patients as soon as possible and formulate effective prevention and management programs，and finally improve the survival outcome of aortic dissection patients.

Key words: Aneurysm, Dissecting, Postoperative Delirium, Risk Factors, Prediction Model, Review, Nursing Care

摘要：

术后谵妄是主动脉夹层患者常见并发症之一，发生率较高，危害性较强。该研究对主动脉夹层患者术后谵妄的类型和特征、危险因素及风险预测模型进行综述，以期为临床医护人员尽早识别主动脉夹层患者谵妄风险，制订有效预防管理方案，改善患者生存结局提供参考。

关键词: 动脉瘤, 夹层, 术后谵妄, 危险因素, 预测模型, 综述, 护理

GONG Cuiying, WANG Jianning, LI Liqun, HUANG Qiuxia, HU Jiaojiao, LIANG Hui. Research progress of risk factors and prediction models of postoperative delirium after aortic dissection[J]. Chinese Journal of Nursing, 2023, 58(2): 179-185.

龚翠颖, 王建宁, 李立群, 黄秋霞, 胡娇娇, 梁慧. 主动脉夹层患者术后谵妄危险因素和预测模型的研究进展[J]. 中华护理杂志, 2023, 58(2): 179-185.

Figures/Tables 1

References 37

[1]	刘亚坤, 刘新明, 张珍, 等. 急性Stanford A型主动脉夹层术后神经系统并发症相关危险因素的Meta分析[J]. 中华胸心血管外科杂志, 2020, 36(12):748-756.
	Liu YK, Liu XM, Zhang Z, et al. A meta-analysis of risk factors of neurological complications in patients after acute type A aortic dissection surgery[J]. Chin J Thorac Cardiovasc Surg, 2020, 36(12):748-756.
[2]	曾冰, 白松杰, 刘冬连, 等. 术后早期全身炎症反应综合征对急性Stanford A型主动脉夹层患者短期预后的影响[J]. 中国胸心血管外科临床杂志, 2021, 28(7):796-800.
	Zeng B, Bai SJ, Liu DL, et al. Effect of early postoperative systemic inflammatory response syndrome(SIRS) on the short-term outcome of patients with acute Stanford type A aortic dissection[J]. Chin J Clin Thorac Cardiovasc Surg, 2021, 28(7):796-800.
[3]	Liu JT, Yang F, Luo SY, et al. Incidence,predictors and outcomes of delirium in complicated type B aortic dissection patients after thoracic endovascular aortic repair[J]. Clin Interv Aging, 2021, 16:1581-1589. DOI URL
[4]	Goldberg TE, Chen C, Wang YJ, et al. Association of delirium with long-term cognitive decline:a meta-analysis[J]. JAMA Neurol, 2020, 77(11):1373-1381. DOI URL
[5]	Shi ZY, Mei XC, Li C, et al. Postoperative delirium is associated with long-term decline in activities of daily living[J]. Anesthesiology, 2019, 131(3):492-500. DOI PMID
[6]	Inouye SK, Westendorp RG, Saczynski JS. Delirium in elderly people[J]. Lancet, 2014, 383(9920):911-922. DOI PMID
[7]	赵俊, 胡晓鸿, 李静, 等. 主动脉夹层术后一过性谵妄患者护理方案的制订及实践[J]. 中华护理杂志, 2019, 54(1):60-63.
	Zhao J, Hu XH, Li J, et al. Effects of modified ABCDE bundle in aortic dissection patients with postoperative delirium[J]. Chin J Nurs, 2019, 54(1):60-63.
[8]	贺清, 薛超, 李步潆, 等. Standford A型主动脉夹层动脉瘤患者杂交手术后谵妄特征及发生的危险因素分析[J]. 陕西医学杂志, 2020, 49(11):1432-1435.
	He Q, Xue C, Li BY, et al. Characteristics and risk factors of delirium after hybrid surgery in patients with Standford type A aortic dissecting aneurysm[J]. Shaanxi Med J, 2020, 49(11):1432-1435.
[9]	Lin YJ, Chen Q, Zhang HR, et al. Risk factors for postoperative delirium in patients with triple-branched stent graft implantation[J]. J Cardiothorac Surg, 2020, 15(1):171. DOI PMID
[10]	石娥, 汪露, 张淑芬. Stanford A型主动脉夹层术后谵妄的发生危险因素的研究[J]. 当代护士(中旬刊), 2018, 25(6):40-42.
	Shi E, Wang L, Zhang SF. Study on risk factors of postoperative delirium of Stanford A aortic dissection[J]. Today Nurse, 2018, 25(6):40-42.
[11]	Lv XC, Lin Y, Wu QS, et al. Plasma interleukin-6 is a potential predictive biomarker for postoperative delirium among acute type a aortic dissection patients treated with open surgical repair[J]. J Cardiothorac Surg, 2021, 16(1):146. DOI URL
[12]	牛永胜, 李莉, 魏海燕, 等. 急性A型主动脉夹层患者术后谵妄的危险因素[J]. 临床麻醉学杂志, 2022, 38(6):622-626.
	Niu YS, Li L, Wei HY, et al. Risk factors of postoperative delirium in patients with acute type A aortic dissection[J]. J Clin Anesthesiol, 2022, 38(6):622-626.
[13]	王殊. Stanford A型主动脉夹层术后谵妄危险因素分析[D]. 南京: 南京医科大学, 2018.
	Wang S. Research on the risk factors for delirium of stanford type A aortic dissection patients after surgery[D]. Nanjing: Nanjing Medical University, 2018.
[14]	李梦倩, 李涛, 刘肇瑞, 等. 认知促进治疗对于老年性痴呆患者治疗效果的meta分析[J]. 中国心理卫生杂志, 2021, 35(2):95-101.
	Li MQ, Li T, Liu ZR, et al. A meta-analysis of effect of cognitive stimulation therapy for patients with senile dementia[J]. Chin Ment Health J, 2021, 35(2):95-101.
[15]	Shi QK, Mu XW, Zhang C, et al. Risk factors for postoperative delirium in type A aortic dissection patients:a retrospective study[J]. Med Sci Monit, 2019, 25:3692-3699. DOI URL
[16]	Langhammer B, Sagbakken M, Kvaal K, et al. Music therapy and physical activity to ease anxiety,restlessness,irritability,and aggression in individuals with dementia with signs of frontotemporal lobe degeneration[J]. J Psychosoc Nurs Ment Health Serv, 2019, 57(5):29-37.
[17]	Fu ZL, Xu Q, Zhang CY, et al. Admission systolic blood pressure predicts post-operative delirium of acute aortic dissection patients in the intensive care unit[J]. Int J Gen Med, 2021, 14:5939-5948. DOI PMID
[18]	黄真锋, 法宪恩, 王宏山, 等. 急性主动脉夹层弓部手术后谵妄的临床研究[J]. 东南大学学报(医学版), 2018, 37(2):259-262.
	Huang ZF, Fa XE, Wang HS, et al. Clinical study of delirium after aortic arch operation for acute aortic dissection[J]. J Southeast Univ Med Sci Ed, 2018, 37(2):259-262.
[19]	Lin YJ, Lin LY, Peng YC, et al. Association between glucose variability and postoperative delirium in acute aortic dissection patients:an observational study[J]. J Cardiothorac Surg, 2021, 16(1):82. DOI URL
[20]	Kamenskaya OV, Loginova IY, Klinkova AS, et al. Predictors of neurological complications during surgical treatment of the ascending aorta and aortic arch chronic dissection[J]. Zh Nevrol Psikhiatr Im S S Korsakova, 2018, 118(7):12-17.
[21]	孟令达. 主动脉弓部手术术后早期谵妄发生的危险因素分析[D]. 沈阳: 中国医科大学, 2021.
	Meng LD. Analysis on the risk factors of early postoperative delirium under aortic arch surgery[D]. Shenyang: China Medical University, 2021.
[22]	朱悦倩, 杨菁, 孙煦, 等. 急性Stanford A型夹层术后谵妄的危险因素分析[J]. 实用医学杂志, 2020, 36(7):940-943.
	Zhu YQ, Yang J, Sun X, et al. Analysis of risk factors of postoperative delirium in patients with acute Stanford type A dissection[J]. J Pract Med, 2020, 36(7):940-943.
[23]	Zdravkovic D, Nesic I, Zivkovic IS, et al. Risk factors for neurological dysfunctions after surgical repair of acute aortic dissection type A[J]. Pol J Cardio Thorac Surg, 2020, 17(2):70-75.
[24]	晁珂, 何发明, 李晓召, 等. 急性A型主动脉夹层术后谵妄的影响因素[J]. 心肺血管病杂志, 2022, 41(8):909-913.
	Chao K, He FM, Li XZ, et al. Influencing factors of postoperative delirium in patients with acute type A aortic dissection[J]. J Cardiovasc Pulm Dis, 2022, 41(8):909-913.
[25]	Geube M, Sale S, Svensson L. Con:routine use of brain perfusion techniques is not supported in deep hypothermic circulatory arrest[J]. J Cardiothorac Vasc Anesth, 2017, 31(5):1905-1909. DOI URL
[26]	施乾坤. A型主动脉夹层术后谵妄及肾损伤风险因素的研究[D]. 南京: 南京医科大学, 2020.
	Shi QK. Analysis of risk factors of delirium and acute kidney injury after type A aortic dissection[D]. Nanjing: Nanjing Medical University, 2020.
[27]	Guan XL, Gong M, Wang XL, et al. Low preoperative fibrinogen level is risk factor for neurological complications in acute aortic dissection[J]. Medicine(Baltimore), 2018, 97(21):e10830.
[28]	Song YY, Liu L, Jiang B, et al. Risk factors of cerebral complications after Stanford type A aortic dissection undergoing arch surgery[J]. Asian J Surg, 2022, 45(1):456-460. DOI URL
[29]	Cai SN, Zhang XM, Pan WY, et al. Prevalence,predictors,and early outcomes of post-operative delirium in patients with type A aortic dissection during intensive care unit stay[J]. Front Med(Lausanne), 2020, 7:572581.
[30]	刘海棠, 唐倩芸, 周森. 老年病人心脏术后谵妄风险列线图预测模型的建立及验证[J]. 实用老年医学, 2021, 35(8):840-844.
	Liu HT, Tang QY, Zhou S. Establishment and validation of nomogram model for prediction of delirium risk in elderly patients after cardiac surgery[J]. Pract Geriatr, 2021, 35(8):840-844.
[31]	de la Varga-Martínez O, Gómez-Pesquera E, Muñoz-Moreno MF, et al. Development and validation of a delirium risk prediction preoperative model for cardiac surgery patients(DELIPRECAS):an observational multicentre study[J]. J Clin Anesth, 2021, 69:110158. DOI PMID
[32]	吕晓青. A型主动脉夹层术后神经系统并发症风险因素分析及风险模型构建[D]. 北京: 北京工业大学, 2017.
	Lü XQ. Type A aortic dissection postoperative neurological complications risk factors analysis and risk model building[D]. Beijing: Beijing University of Technology, 2017.
[33]	赵艳艳. 主动脉夹层患者术后谵妄风险预测模型的构建[D]. 十堰: 湖北医药学院, 2022.
	Zhao YY. Postperative delirium in patients with aortic dissection construction of risk prediction model[D]. Shiyan: Hubei University of Medicine, 2022.
[34]	李雪苹, 王磊, 张淮, 等. Stanford A型主动脉夹层患者术后谵妄风险预测评分模型的构建与效果验证[J]. 中华护理杂志, 2022, 57(8):950-957. DOI
	Li XP, Wang L, Zhang H, et al. Construction and evaluation of a risk prediction model of postoperative delirium in patients with Stanford type A aortic dissection[J]. Chin J Nurs, 2022, 57(8):950-957. DOI
[35]	He JF, Ling Q, Chen YH. Construction and application of a model for predicting the risk of delirium in postoperative patients with type A aortic dissection[J]. Front Surg, 2021, 8:772675. DOI URL
[36]	de la Varga-Martínez O, Gómez-Pesquera E, Muñoz-Moreno MF, et al. Influence of intraoperative and postoperative factors on the predictive capacity of the delirium risk model for cardiac surgery patients(DELIPRECAS):an observational multicentre study[J]. J Clin Anesth, 2021, 72:110282. DOI PMID
[37]	李珂, 杨振楠. PICC相关血流感染风险预测模型的研究进展[J]. 中华护理杂志, 2022, 57(5):551-554. DOI
	Li K, Yang ZN. Research progress of PICC catheter related blood stream infection risk prediction model[J]. Chin J Nurs, 2022, 57(5):551-554. DOI