[Acute postoperative psychosyndromes. A prospective study and multivariate analysis of risk factors].
The incidence of postoperative delirium was assessed in 92 patients on a general surgical intensive care unit. Postoperative delirium was diagnosed in 39 patients (42%). Most of the cases were diagnosed on the second postoperative day and the median duration was seven days. Ten patients with delirium (25%) had a lethal outcome, compared to a 13% mortality of the whole population. In univariate analysis the variables age, preoperative therapy for heart failure, respirator therapy, dobutamin therapy and lowest capillary pO2 on day one were significantly associated with later development of delirium, whereas preoperative peritonitis, and history of stroke or hypertension were only borderline significant. A predictive model with three parameters emerged from multiple logistic regression analysis: after correction for age (p = 0.001), respirator therapy (p = 0.020), and capillary pO2 on day one (p = 0.049) none of the remaining variables proved of additional significance. The statistical model yielded a predictive accuracy of 78%.
Dieckelmann
A
A
Chirurgische Klinik, Ruhr-Universität Bochum.
Haupts
M
M
Kaliwoda
A
A
Rembs
E
E
Haan
J
J
Zumtobel
V
V
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001925:Brain Damage, Chronic / Q000209:etiology; D003693:Delirium / Q000209:etiology; D004280:Dobutamine / Q000009:adverse effects; D005260:Female; D006333:Heart Failure / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D019965:Neurocognitive Disorders / Q000209:etiology*; D010100:Oxygen / Q000097:blood; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D012121:Respiration, Artificial; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
D004280:Dobutamine; D010100:Oxygen
Akute postoperative Psychosyndrome. Eine prospektive Studie und multivariate Analyse von Risikofaktoren.