Frontiers in cardiovascular medicine · 2026
Incidence and independent risk factors for postoperative delirium in ICU patients after cardiopulmonary bypass cardiac surgery: a retrospective cohort study.
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Zhang Chunyan, Yu Huan, Zhai Wei, Zhang Lili, Li Qing, Li Yuanyuan
Аннотация
OBJECTIVE: This study aims to investigate the incidence of delirium in patients admitted to the intensive care unit (ICU) after extracorporeal circulation cardiac surgery and analyze the key influencing factors.
METHOD: A retrospective cohort study was conducted. 302 patients who underwent extracorporeal circulation cardiac surgery and were transferred to the ICU in our hospital from January 2023 to June 2025 were continuously included. According to the ICDSC results in the ICU nursing records, the patients were divided into the delirium group (POD, n = 85) and the non-delirium group (Non-POD, n = 217). Baseline data, perioperative and early postoperative indicators were compared. Multivariate logistic regression identified independent risk factors, and SHAP, ROC curves were analyzed.
RESULT: The incidence of POD was 28.15%. Compared with the Non-POD group, the POD group had significantly higher age, APACHE II score, sedative use, postoperative hypotension rate, and lower albumin level, as well as longer aortic cross-clamping time, cardiopulmonary bypass time, and mechanical ventilation time (all P < 0.05). Multivariate analysis showed that older age, longer mechanical ventilation time, longer aortic cross-clamping time, higher APACHE II score, and lower albumin levels were independent risk factors (AUC: 0.719, 0.769, 0.677, 0.782, and 0.845, respectively, Mean |SHAP|: 1.58, 1.96, 1.01, 0.95, 2.81).
CONCLUSION: The incidence of POD after extracorporeal circulation cardiac surgery is relatively high. Its occurrence is closely related to advanced age, aortic cross-clamping time, postoperative mechanical ventilation time, APACHE II score, and albumin content. ICU nursing records can effectively identify high-risk patients. The research results provide key evidence for early warning, risk stratification, and the formulation of targeted prevention and intervention strategies in clinical nursing practice.
METHOD: A retrospective cohort study was conducted. 302 patients who underwent extracorporeal circulation cardiac surgery and were transferred to the ICU in our hospital from January 2023 to June 2025 were continuously included. According to the ICDSC results in the ICU nursing records, the patients were divided into the delirium group (POD, n = 85) and the non-delirium group (Non-POD, n = 217). Baseline data, perioperative and early postoperative indicators were compared. Multivariate logistic regression identified independent risk factors, and SHAP, ROC curves were analyzed.
RESULT: The incidence of POD was 28.15%. Compared with the Non-POD group, the POD group had significantly higher age, APACHE II score, sedative use, postoperative hypotension rate, and lower albumin level, as well as longer aortic cross-clamping time, cardiopulmonary bypass time, and mechanical ventilation time (all P < 0.05). Multivariate analysis showed that older age, longer mechanical ventilation time, longer aortic cross-clamping time, higher APACHE II score, and lower albumin levels were independent risk factors (AUC: 0.719, 0.769, 0.677, 0.782, and 0.845, respectively, Mean |SHAP|: 1.58, 1.96, 1.01, 0.95, 2.81).
CONCLUSION: The incidence of POD after extracorporeal circulation cardiac surgery is relatively high. Its occurrence is closely related to advanced age, aortic cross-clamping time, postoperative mechanical ventilation time, APACHE II score, and albumin content. ICU nursing records can effectively identify high-risk patients. The research results provide key evidence for early warning, risk stratification, and the formulation of targeted prevention and intervention strategies in clinical nursing practice.