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Báo cáo y học: "Delirium as a predictor of sepsis in post-coronary artery bypass grafting patients: a retrospective cohort study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Delirium as a predictor of sepsis in post-coronary artery bypass grafting patients: a retrospective cohort study. | Martin et al. Critical Care 2010 14 R171 http ccforum.eom content 14 5 R171 c CRITICAL CARE RESEARCH Open Access Delirium as a predictor of sepsis in post-coronary artery bypass grafting patients a retrospective cohort study Billie-Jean Martin1 Karen J Buth2 Rakesh C Arora3t Roger JF Baskett2 3 Abstract Introduction Delirium is the most common neurological complication following cardiac surgery. Much research has focused on potential causes of delirium however the sequelae of delirium have not been well investigated. The objective of this study was to investigate the relationship between delirium and sepsis post coronary artery bypass grafting CABG and to determine if delirium is a predictor of sepsis. Methods Peri-operative data were collected prospectively on all patients. Subjects were identified as having agitated delirium if they experienced a short-term mental disturbance marked by confusion illusions and cerebral excitement. Patient characteristics were compared between those who became delirious and those who did not. The primary outcome of interest was post-operative sepsis. The association of delirium with sepsis was assessed by logistic regression adjusting for differences in age acuity and co-morbidities. Results Among 14 301 patients 981 became delirious and 227 developed sepsis post-operatively. Rates of delirium increased over the years of the study from 4.8 to 8.0 P 0.0003 . A total of 70 patients of the 227 with sepsis were delirious. In 30.8 of patients delirium preceded the development of overt sepsis by at least 48 hours. Multivariate analysis identified several factors associated with sepsis receiver operating characteristic ROC 79.3 delirium odds ratio OR 2.3 95 confidence interval CI 1.6 to 3.4 emergent surgery OR 3.3 CI 2.2 to 5.1 age OR 1.2 CI 1.0 to 1.3 pre-operative length of stay LOS more than seven days OR 1.6 CI 1.1 to 2.3 pre-operative renal insufficiency OR 1.9 CI 1.2 to 2.9 and complex coronary disease OR 3.1 CI 1.8 to 5.3 . .