Analysis of correlation between rewarming time and delirium after aortic dissection type A

LIU Hua-Xue; WANG Rui; LI Fang; CHEN Zu-Jun

doi:10.3969/j.issn.1672-5301.2023.12.011

Abstract：Objective To analyze the correlation between rewarming time and delirium after aortic dissection type A.Methods The data of 295 patients undergoing type A surgery after aortic dissection were retrospectively analyzed in the Department of Surgery SICU,National Cardiovascular Center,Peking Union Medical College,Chinese Academy of Medical Sciences,Fuwai Hospital,from January 2020 to December 2022,including basic information,underlying diseases,operation time,postoperative maximum sodium ion value,creatinine value,total bilirubin value,and the following:Direct bilirubin value,hypothermia stop time,brain protection mode and postoperative delirium occurrence.Results A total of 295 patients were included in the study,119 of whom developed postoperative delirium(40.3%).A total of 47 patients had an immediate temperature above 36℃,and 22 had delirium.The total number of people who rewarmed at 36℃for 1-5 h was 161,and the number of delirium occurred in 10 people,with an incidence of 6.2%.The total number of patients with 6-10 h rewarming at 36℃was 76,and delirium occurred in all the cases,with an incidence of 100%.Eleven patients with rewarming time>10 h experienced delirium,with an incidence of 100%.The difference was statistically significant(χ2=207.1,P≤0.01).Multivariate logistic regression analysis showed that after controlling for stroke history,emergency surgery,maximum sodium ion value,creatinine value,operation time deep hypothermia circulatory arrest time,cerebral protection,the longer rewarming time(OR=3.01,95%CI 1.22-7.38,P<0.02),the higher the risk of postoperative delirium.Conclusion The longer rewarming time after aortic dissection type A,the higher the risk of delirium.