Clinical study on influencing factors of early cognitive dysfunction in critically ill patients after ICU
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摘要: 目的 探究危重症患者ICU治疗后早期(3个月内)认知功能障碍的临床相关因素。 方法 选取2014年1月—2019年12月亳州市人民医院经ICU收治后出院或转出的危重症患者165例,根据是否存在认知功能障碍分为A组(无认知功能障碍,135例)和B组(认知功能障碍组,30例),收集2组患者相关临床资料,采用多因素logistic回归分析探究ICU治疗后早期认知功能障碍的临床相关因素。 结果 ICU治疗后患者早期认知功能障碍发病率为18.18%(30/165),多因素logistic回归分析显示年龄(OR=1.187,95%CI:1.085~1.299,P<0.001)、病程急性生理健康评分-Ⅱ(APACHEⅡ)最高分(OR=1.392,95%CI:1.170~1.657,P<0.001)、入住ICU时长(OR=1.089,95%CI:1.016~1.166,P<0.001)为危重症患者ICU治疗后认知功能障碍的独立危险因素;无谵妄发生(OR=0.209,95%CI:0.054~0.803,P=0.023)为危重症患者ICU治疗后认知功能障碍的保护性因素。 结论 年龄、APACHEⅡ最高分、入住ICU时长为危重症患者ICU治疗后早期(3个月)认知功能障碍的影响因素,低谵妄发生率为其保护性因素,临床应关注危重患者认知功能障碍的影响因素,以减少危重患者ICU治疗后认知功能障碍的发生。Abstract: Objective To explore the influencing factors of early cognitive dysfunction in critically ill patients after ICU. Methods Total 165 critically ill patients discharged or transferred out of Bozhou people's hospital after receiving treatment in ICU from January 2014 to December 2019 were selected. They were divided into group A(no cognitive dysfunction, 135 cases) and group B(cognitive dysfunction, 30 cases) according to whether there was cognitive dysfunction. The basic data of the two groups were collected. The influencing factors of early cognitive impairment in post-intensive care patients were analyzed by multivariate logistic regression. Results The incidence of early cognitive impairment in post-intensive care patients was 18.18%(30/165). Multivariate logistic regression analysis indicated that the age(OR=1.187, 95% CI:1.085-1.299, P<0.001), acute physiological health score-Ⅱ(APACHEⅡ) maximum score in the course of disease(OR=1.392, 95% CI:1.170-1.657, P<0.001), ICU stay time(OR=1.089, 95% CI:1.016-1.166, P<0.001) were risk factors for cognitive impairment in post-intensive care patients. The no delirium(OR=0.209, 95% CI:0.054-0.803, P=0.023) was negatively correlated with the degree of cognitive dysfunction. Conclusion The age, APACHEⅡ maximum score in the course of disease, ICU stay time are the main influencing factors of early cognitive dysfunction(within 3 months) in post-intensive care patients. The no delirium is its protective factor. Clinicians should pay attention to the influencing factors of cognitive dysfunction and reduce the incidence of cognitive impairment in post-intensive care patients.
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Key words:
- Cognitive dysfunction /
- Post-intensive care patients /
- Risk factor
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