title: Incidence and Risk Factors of Delirium in Patients After Type-A Aortic Dissection Surgery.
abstract: OBJECTIVE
  To study the incidence and related risk factors for postoperative delirium after type-A aortic dissection in patients who underwent Sun's procedure (total arch replacement using a tetrafurcate graft with stented elephant trunk implantation).
  
  
  METHODS
  A retrospective study.
  
  
  METHODS
  A cardiac surgical intensive care unit.
  
  
  METHODS
  The study comprised 100 patients admitted to the intensive care unit for type-A aortic dissection.
  
  
  METHODS
  All patients underwent Sun's procedure with uniform preoperative and anesthetic treatment.
  
  
  RESULTS
  Delirium was evaluated using the Confusion Assessment Method for the intensive care unit. Baseline demographics and preoperative, intraoperative, and postoperative data were recorded and analyzed retrospectively via univariate analysis and multivariate logistic regression. The incidence of postoperative delirium was 34%, according to Confusion Assessment Method for the intensive care unit criteria. Univariate analysis revealed that 17 variables differed significantly among patients with and without delirium. Additional multivariate stepwise logistic regression analysis confirmed that cerebrovascular disease history, surgery duration, cardiopulmonary bypass duration, intubation time, and hypoxia were strongly associated with postoperative delirium.
  
  
  CONCLUSIONS
  Delirium is a common postoperative complication of aortic dissection. Cerebrovascular disease history, surgery and cardiopulmonary bypass duration, postoperative hypoxia, and intubation time are independently associated with the development of delirium. Early diagnosis of delirium and modifying these factors properly may be helpful to improve patients' prognosis.
authors.affiliation: Department of Cardiovascular Surgery, Qilu Hospital, Shandong University, Shandong, China.
authors.forename: Zhengqin
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Cardiovascular Surgery, Qilu Hospital, Shandong University, Shandong, China.
authors.forename: Xinyan
authors.initials: X
authors.lastname: Pang
authors.affiliation: Department of Cardiovascular Surgery, Qilu Hospital, Shandong University, Shandong, China.
authors.forename: Xiquan
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Cardiovascular Surgery, Qilu Hospital, Shandong University, Shandong, China.
authors.forename: Guangqing
authors.initials: G
authors.lastname: Cao
authors.affiliation: Department of Cardiovascular Surgery, Qilu Hospital, Shandong University, Shandong, China.
authors.forename: Changcun
authors.initials: C
authors.lastname: Fang
authors.affiliation: Department of Cardiovascular Surgery, Qilu Hospital, Shandong University, Shandong, China. Electronic address: robustguo@sina.com.
authors.forename: Shuming
authors.initials: S
authors.lastname: Wu
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000503:physiopathology / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000639:trends; D003693:Delirium / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors
keywords: delirium; incidence; risk factors; type-A aortic dissection