ICU机械通气病人亚谵妄综合征发生现状及危险因素研究

    The current situation and risk factors of subdelirium syndrome in ICU patients with mechanical ventilation

    • 摘要:
      目的: 分析机械通气病人亚谵妄综合征(SSD)发生现状及其危险因素。
      方法: 便利抽样法选取2023入住安徽省某三甲医院ICU 279例机械通气病人为研究对象,使用ICU意识模糊评定法(the confusion assessment method for the ICU,CAM–ICU)将病人分为SSD组和非SSD组,采用单因素和二元logistic回归分析ICU机械通气病人发生SSD的危险因素,采用ROC曲线分析各危险因素对SSD发生的预测效能。
      结果: 279例机械通气病人发生SSD 228例(81.72%),机械通气前3天发生SSD 180例(78.94%),34例SSD病人出现反复现象。二元 logistic回归分析显示,年龄、APACHE–Ⅱ评分、CPOT评分、机械通气时间、C–反应蛋白、收缩压是ICU机械通气病人发生SSD的独立危险因素,ROC曲线分析显示,年龄、APACHE–Ⅱ评分、机械通气时间、C–反应蛋白的曲线下面积及95%CI分别为0.733(95%CI:0.658 ~ 0.807)、0.795(95%CI:0.737 ~ 0.853)、0.797(95%CI:0.734 ~ 0.860)、 0.589(95%CI:0.516 ~ 0.662)(P<0.01)。
      结论: ICU机械通气病人SSD发生率较高,机械通气4天内发病率高,可出现反复现象,年龄、APACHE–Ⅱ评分、CPOT评分、机械通气时间、收缩压及C–反应蛋白为其发生SSD的独立危险因素,且年龄、APACHE–Ⅱ评分、CPOT评分预测效能良好。

       

      Abstract:
      Objective To investigate the current status of the occurrence of subdelirium syndrome (SSD) in mechanically ventilated patients and its risk factors.
      Methods A total of 279 patients with mechanical ventilation admitted to the ICU of a tertiary hospital in Anhui Province in 2023 were selected as the research objects by the convenience sampling method, and the confusion assessment method for the ICU was used. The patients were divided into the SSD group and non-SSD group. Univariate and binary logistic regression were used to analyze the risk factors for the occurrence of SSD in ICU patients with mechanical ventilation, and the ROC curve was used to analyze the predictive efficacy of each risk factor for the occurrence of SSD.
      Results Among 279 patients with mechanical ventilation, 228 cases (81.72%) developed SSD, 180 cases (78.94%) developed SSD before 3 days of mechanical ventilation, and 34 patients with SSD experienced recurrence. Binary logistic regression analysis showed that the age, APACHE-II score, CPOT score, mechanical ventilation time, C-reactive protein and systolic blood pressure were the independent risk factors for SSD in ICU patients with mechanical ventilation. The results of ROC curve analysis showed that the age, APACHE-II score, mechanical ventilation time, area under the curve of C-reactive protein and 95%CI were 0.733 (95%CI: 0.658–0.807), 0.795 (95%CI: 0.737–0.853), 0.797 (95%CI: 0.734–0.860), 0.589 (95%CI: 0.516–0.662), respectively (P < 0.01).
      Conclusions The incidence of SSD in ICU patients with mechanical ventilation is relatively high. The incidence is high within 4 days of mechanical ventilation, and recurrence may occur. The age, APACHE-II score, CPOT score, mechanical ventilation time, systolic blood pressure and C-reactive protein are the independent risk factors for the occurrence of SSD, and the age, APACHE-II score and CPOT score have good predictive efficacy.

       

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