Analysis of related factors of early cognitive dysfunction in patients with septic shock after recovery

Objective To explore the influencing factors of early cognitive dysfunction in patients with septic shock after recovery. Methods Total 124 patients with septic shock in intensive care unit(ICU) of Bozhou people's hospital from January 2015 to December 2019 were divided into cognitive impairment group(33 cases, CI group) and non-cognitive impairment group(91 cases, NCI group) according to the Montreal Assessment Scale Cognitive(Chinese version). Data of patients were collected, which included, age, the highest acute physiology, chronic health score-Ⅱ(APACHE-Ⅱ), total norepinephrine(NE), total benzodiazepine(BZD), total propofol(PROP), total opioid dosage, time in ICU, time of mechanical ventilation, the highest content of serum high sensitive C protein(hs-CRP), the highest value of arterial blood lactic acid(LAC), and the duration of delirium. The clinical data of the two groups were compared. The single factor screening and multifactor logistic regression analysis of early cognitive impairment in patients with septic shock after ICU cure were performed. The early cognitive impairment factors in patients was analyzed by univariate screening and multivariate logistic regression analysis. Results The incidence of early cognitive impairment in post-intensive care patients with septic shock was 26.61%(33/124). The age and duration of delirium in CI group[(67.19±6.55) year,(32.97±27.59) h)] were higher than those in NCI group[(50.96±11.94) year,(3.29±4.48) h](all P<0.05). Multivariate logistic regression analysis indicated that the age(OR=1.279, 95% CI:1.128-1.451, P<0.001) and the duration of delirium(OR=1.355, 95% CI:1.69-1.571, P<0.001)) were risk factors for cognitive impairment post-intensive care patients with septic shock. Conclusion The incidence of early cognitive impairment(3 months) is higher in patients with septic shock after recovery. The age and duration of delirium are the main influencing factors of early cognitive dysfunction(within 3 months) in those patients. Clinical staff should take measures to shorten the duration of delirium as early as possible and screen for cognitive impairment in patients with septic shock who are older or have a longer duration of delirium.