Journal of Psychology & Psychotherapy
Open Access

Abstract

Incidence and Risk Factors of Sub-Syndromal Delirium in Patients after Cardiac Surgery

Longti Li, Menghe Wang, Xiong Chen*

Introduction: Sub-Syndromal Delirium (SSD) is characterised by a milder state of delirium involving one or more symptoms of delirium, without the complete syndrome. Both delirium and SSD in the ICU are recognised as determinants of long-term functional impairment and cognitive impairment, but few studies on SSD results have been reported. The incidence rates of delirium and SSD have been based on earlier studies involving various patient groups in different hospital units. Few studies on incidence of SSD in patients after cardiac surgery have been reported. Here, we investigated the incidence and risk factors of SSD in patients after cardiac surgery.

Methods: 378 patients who underwent cardiac surgery in our institution were recruited and screened. In order to diagnose delirium, the evaluation method was used to evaluate the symptoms of delirium and DSM-5 criteria. SSD is defined as one or more core features of delirium without satisfying diagnostic criteria. Independent samples t test was used for comparison between two groups; binary logistic regression analysis was performed on variables with statistically significant differences in uni variate analysis to find independent risk factors for SSD after cardiac surgery.

Results: Among 378 subjects, 112 (29.63%) had Sub-Syndromal Delirium (SSD) and 28 (7.41%) had delirium and the remaining 238 patients (62.96%) were without delirium. Univariate analysis showed that: Age, APACHE II score, duration of aortic clamping, length of ICU stays, duration of sedation use and daily sleep time were the risk factors for the occurrence of SSD (P<0.05). Logistic regression analysis showed that age >70 years old, APACHE II score >20 points, length of ICU stay>5 d and duration of sedation use >24 h were independent risk factors for SSD after cardiac surgery (P<0.05). Fit a functional model for predicting SSD after cardiac surgery according to the analysis results of the binary logistic regression model, namely logit P=1.472X1+2.213X2 +3.028X3 +1.306X4, in the function, X1 is the age (>70 years old), X2 is the APACHE II score (>20 points), X3 is the length of ICU stay (>5 d), X4 is the duration of sedation use (>24 h).

Conclusion: Patients undergoing cardiac surgery should be clinically comprehensively assessed and appropriate precautions for patients with these risk factors. Preventive treatment should be carried out for the treatment of such a patient and the consciousness state is closely observed after the operation and moderate intervention should be carried out.

Published Date: 2025-02-10; Received Date: 2024-04-19