Factors Predicting Acute Post-Operative Delirium in Peripheral Arterial Disease Patients
Keywords:
post-operative delirium, peripheral arterial disease, serum albumin, sleep quality, post-operative analgesic administrationAbstract
Objective: To investigate the rate of acute post-operative delirium and the predictive power of sleep quality, pre-operative serum albumin level, and post-operative analgesics, on acute post-operative delirium (POD) in peripheral arterial disease (PAD) surgery patients
Design: Descriptive predictive study design
Methodology: The sample comprised 130 PAD patients having undergone vascular surgery at two tertiary hospitals. The patients were monitored during the frst to the seventh days after the surgery, according to the predetermined requirements. The instruments for data collection consisted of 1) the Thai version of the Pittsburg Sleep Quality Index; 2) a postoperative analgesic administration record; and 3) the Thai version of the Confusion Assessment Method. The data were analysed using descriptive statistics and binary logistic regression analysis, with the signifcance level set at .05.
Results: The majority of the patients (63.8%) were male, averagely aged 65.83 years (SD = 13.63). Most cases of PAD found (71.5%) were of the chronic type, with 86% having critical limb ischaemia. Acute POD was found in 10.8% of the patients, with 64.29% (mean = 42.86 ± 31.47 hours) occurring in the first 24 hours after surgery. Multiple symptoms were found in 42.86% of the patients, 50% of whom had acute POD within one to three days after surgery (mean = 3 ± 1.62 days). A predictive power analysis revealed that the pre-operative serum albumin level of lower than 3.5 g/dL was capable of significantly predicting occurrences of acute POD (OR 8.51, 95% CI [1.06-68.06], p = .044).
Recommendations: The pre-operative serum albumin level has significant power to predict occurrences of acute POD in PAD patients. Nurse, the refore, should consider assessing the albumin level pre-operatively in order to prevent acute POD.
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