Clinical study on postoperative delirium in senile patients undergoing coronary artery bypass grafting and its correlation with apolipoprotein E gene polymorphism
Abstract：Objective To investigate the postoperative delirium in senile patients undergoing off-pump coronary artery bypass grafting (OFF-CABG), and to explore the correlation between postoperative delirium and apolipoprotein E (ApoE) gene polymorphism.Methods Ninety-eight patients (>65 years) after coronary artery bypass grafting were enrolled in the sudy.According to the patients with postoperative delirium or without postoperative delirium,these patients were divided into observation group and control group.Taking delirium rating scale-revised-98 (DRS-R-98) as diagnosis criteria to analyze the incidence rate and risk factors of postoperative delirium.Moreover the genome DNA was extracted from whole blood samples of patients before surgery and ApoE genetypes were detected by gene sequencing.Results The incidence rate of postoperative delirium was 9.2% (9/98),in which,the delirium duration <24h accounted for 77.8% (7/9), delirium duration >2d accounted for 11.1% (1/9).The univariate Logistic regression analysis results showed that the occurrence of postoperative delirium was correlated to previous cerebral infarction (P<0.01), previous cerebral heamorrhage (P<0.05),carotid artery stenosis (P<0.01), surgery duration (P<0.05),mean artery pressure (P<0.05),the time staying in intensive care unit (P<0.05).In observation group, one patient had ApoE ε4/4 allele,however in control group two patients had ApoE ε4/4 allele,there was a significant difference in ApoE ε4/4 allele between two groups (P<0.05).Conclusion The susceptivity detection of ApoE gene for the patients with previous cerebral infarction may be helpful to evaluate the risk of occurrence of postoperative delirium.
Keywords：coronary artery bypass graftingpostoperative deliriumincidence raterisk factorsapolipoprotein E
Publication Date：2017-01-01