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Nursing in critical care · 2025

Associations of Intensive Care Unit Acquired Weakness and Postoperative Delirium in Surgical Intensive Care Unit: A Prospective Observation Study.

СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Qiu Jin, Meng Yingtong, Yang Zhiqing, Ren Rongrong, Chen Jiao, Huang Hanjun, Feng Tienan, Ge Xiaohua

Аннотация

BACKGROUND: To date, studies assessing the relationship between intensive care unit acquired weakness (ICU-AW) and postoperative delirium (POD), two of the most common complications in the intensive care unit (ICU), are lacking.

AIM: To explore the association of the occurrence of POD, POD subtypes and POD duration with ICU-AW in a surgical intensive care unit (SICU).

STUDY DESIGN: This study was a prospective observational study. Four hundred and two postoperative patients in a SICU at a tertiary hospital in Shanghai, China, participated in the study. Data were collected through the electronic medical record system of the hospital between October 2022 and July 2023. POD was assessed using the Richmond agitation-sedation scale (RASS) and the Confusion Assessment Method for the intensive care unit (CAM-ICU). The Medical Research Council score (MRC score) was used to measure ICU-AW. The bivariate logistic regression analysis was used to analyse the relationship between ICU-AW and POD, and further, the influencing factors of ICU-AW.

RESULTS: Of the 402 analysed patients (mean age: 69.2 ± 14.84, 59.7% male), 121 (30.10%) patients developed ICU-AW, and 92 (22.89%) patients developed POD. Of the ICU-AW group, 53 (43.80%) patients screened positive for POD. The occurrence of POD (odds ratio (OR), 0.227 95% CI: 0.052-0.981), hypoactive POD (OR, 4.241 95% CI: 1.490-12.072) and POD duration (OR, 2.649; 95% CI: 1.422-4.935) were independently associated with ICU-AW. Moreover, diabetes (OR, 1.710; 95% CI: 1.036-2.823) and Interleukin-6 (IL-6) (OR, 1.001; 95% CI: 1.000-1.001) were also significantly correlated with ICU-AW.

CONCLUSIONS: ICU-AW was associated with POD, POD subtypes and POD duration in the SICU patients. Screening for hypoactive POD should be used as part of routine risk assessment in the SICU focused on identifying ICU-AW and specifying a timely and targeted plan during the early stages of the postoperative period.

RELEVANCE TO CLINICAL PRACTICE: While closely monitoring ICU patients with high IL-6 levels and diabetes, nurses should assess the type and duration of POD in patients and implement care interventions to prevent the development of ICU-AW.

Предметные рубрики MeSH

ИП Урсолов Владлен Сергеевич

ИНН 500118482352 · ОГРНИП 314500117700049

Реквизиты и контакты