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Feature Analysis for Evaluating the Risk of Postoperative Delirium in Pediatric Patients
Andrzej Czyrski1, Jowita Rosada-Kurasińska2, Weronika Ziętkiewicz3
1Poznan University of Medical Sciences, Department of Physical Pharmacy and Pharmacokinetics, Rokietnicka 3 Street, 60-806 Poznań, Poland.
Insights
Postoperative delirium in children is common after general anesthesia, affecting up to 60% of patients. Chronic disease and pain are key risk factors, impacting behavior post-discharge.
Area of Science:
- Pediatric Anesthesiology
- Intensive Care Medicine
- Neuroscience
Background:
- Postoperative delirium is a frequent complication in pediatric patients undergoing general anesthesia.
- Symptoms include disturbances in consciousness, attention, perception, and disorientation.
- The Confusion Assessment Protocol for the Demented (CAPD) and Pediatric Anesthesia Emergence Delirium (PAED) scales assess delirium occurrence.
Purpose of the Study:
- To evaluate the incidence and risk factors of postoperative delirium in pediatric patients.
- To assess the correlation between the CAPD and PAED scales in this population.
- To identify factors associated with delirium development and its impact on behavior.
Main Methods:
- A single-center observational cohort study included 89 pediatric patients.
- Delirium was assessed post-anesthesia using the CAPD and PAED scales.
- Correlation and feature analyses were performed to identify risk factors and scale relationships.
Main Results:
- Delirium incidence was 60% (CAPD) and 39% (PAED), with 21% positive on both scales.
- A strong correlation was found between the CAPD and PAED scales.
- Chronic disease and postoperative pain were identified as significant risk factors for delirium.
Conclusions:
- The CAPD and PAED scales show a significant positive correlation in assessing pediatric postoperative delirium.
- Chronic diseases are associated with an increased risk of delirium.
- Postoperative delirium is linked to negative behavioral changes in children within seven days of discharge.
Abstract:
Background/Objectives: Postoperative delirium is an acute condition commonly seen in pediatric patients. It is often observed in intensive care units for patients undergoing general anesthesia. Characteristic symptoms include disturbances of consciousness, attention, perception, or disorientation. The occurrence of delirium can be assessed using the CAPD and PAED scales. Methods: A single-center observational cohort studyof the 2022-2024 results was conducted. A total of 89 patients of the Pediatric Anesthesiology and Intensive Care Unit undergoing procedures under general anesthesia were included in this study. The state of delirium just after the recovery from anesthesia was assessed using the CAPD and PAED scales. Results: A total of 60% of patients experienced delirium taking the results according to the CAPD scale, 39% according to the PAED scale. A score indicating delirium according to both the CAPD and PAED scales was recorded in 21% of the patients examined. The results of the correlation analyses indicate a strong relationship between the CAPD and PAED scales. The feature analysis indicated there was a correlation between the occurrence of delirium and chronic disease. One of the confirmed risk factors for the development of postoperative delirium in children is postoperative pain. The experience of postoperative delirium is associated with the observation of negative postoperative behavioral changes in children within 7 days of hospital discharge. Conclusions: The correlation analysis showed a significant positive relationship between CAPD scale and PAED scale. The feature analysis indicated a relationship between CAPD scores and the existence of chronic diseases.
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