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Risk factors for postoperative delirium in children with congenital heart disease: a prospective nested case-control
1Nursing School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100144, China).
Insights
Younger age, male gender, more invasive catheters, severe pain, and parental anxiety are key risk factors for postoperative delirium (POD) in children with congenital heart disease.
Area of Science:
- Pediatric Cardiology
- Critical Care Medicine
- Neuroscience
Background:
- Postoperative delirium (POD) is a significant concern in pediatric patients undergoing surgery for congenital heart disease (CHD).
- Identifying risk factors for POD is crucial for developing targeted prevention strategies and improving patient outcomes.
Purpose of the Study:
- To investigate and identify independent risk factors associated with the development of postoperative delirium in children with congenital heart disease.
Main Methods:
- A prospective nested case-control study was conducted involving children with CHD who underwent surgery.
- Clinical data were compared between a group that developed POD (n=114) and a control group without POD (n=102).
- Multivariate unconditional logistic regression analysis was employed to determine independent risk factors.
Main Results:
- Younger age (OR=0.951, P<0.001), male gender (OR=2.127, P=0.049), increased number of invasive catheters per day (OR=1.490, P=0.017), higher degree of postoperative pain (OR=5.856, P<0.001), and elevated preoperative parental anxiety (OR=1.025, P=0.010) were identified as independent risk factors for POD.
- These factors significantly increase the likelihood of developing postoperative delirium in this vulnerable population.
Conclusions:
- The study identified several modifiable and non-modifiable risk factors for POD in children with CHD.
- Interventions targeting pain management, minimizing catheter use, and addressing parental anxiety may help reduce the incidence of POD in pediatric cardiac surgery patients.
Objectives:
To study the risk factors for postoperative delirium (POD) in children with congenital heart disease.
Methods:
A prospective nested case-control study was performed on children with congenital heart disease who underwent surgery in Fuwai Hospital, Chinese Academy of Medical Sciences, from December 2020 to June 2021. The clinical data were compared between the POD group (n=114) and non-POD group (n=102). A multivariate unconditional logistic regression analysis was used to investigate the risk factors for POD in children with congenital heart disease.
Results:
The multivariate logistic regression analysis showed that age (OR=0.951, P<0.001), gender (OR=2.127, P=0.049), number of invasive catheters per day (OR=1.490, P=0.017), degree of postoperative pain (OR=5.856, P<0.001), and preoperative parental anxiety level (OR=1.025, P=0.010) were independent risk factors for POD in children with congenital heart disease.
Conclusions:
The risk of POD increases in children with congenital heart disease who are younger, male, have higher number of invasive catheters per day, higher degree of postoperative pain, or higher preoperative parental anxiety level.
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