Karotis endarterektomi sonrası deliryum sıklığı

Abstract

Giriş: İnternal karotis arter stenozu sistemik aterosklerotik hastalığın bir sonucudur. İnternal karotis arter endarterektomisi, ciddi internal karotis arter stenozu olan hastalarda hayatı tehdit eden inmeleri önlemek için kullanılan bir tedavi yöntemidir. Karotis endarterektomi sonrası hastalarda serebral perfüzyon eksikliğine bağlı hemodinamik değişiklikler nedeniyle deliryum görülebilir. Bu çalışma karotis endarterektomi yapılan hastalarda deliryum sıklığını ve risk faktörlerini belirlemek amacıyla yapıldı. Yöntem: Araştırma tanımlayıcı ve kesitsel prospektif bir çalışmadır. Araştırma verileri 2 yılda toplandı ve çalışmaya katılmayı kabul eden 83 hastaya ulaşıldı. Sosyodemografik ve klinik özellikler veri toplama formu, yoğun bakım deliryum tarama kontrol listesi ve ağrı ölçeği kullanıldı. Bulgular: Karotis endarterektomi sonrası hastaların %2.07'sinde deliryum saptandı. Karotis endarterektomi sonrası 2-4 saat içinde deliryum gelişen ve gelişmeyen hastaların oksijen satürasyon ortalamaları arasında istatistiksel olarak anlamlı fark bulundu (p<0.05). Karotis endarterektomi sonrası deliryum gelişen hastaların ameliyat sonrası 2-4. saatlerdeki oksijen satürasyon ortalamaları diğer hastalara göre daha düşüktü. Dört saat ve daha fazla uyuyan hastalarda deliryum diğer hastalara göre daha azdı. Ameliyat sonrası 1. günde deliryum gelişen ve gelişmeyen hastaların ağrı skoru ortalamaları istatistiksel olarak anlamlı bulundu (p<0.05) Sonuç: İnternal karotis arter endarterektomisi sonrası ileri yaş, düşük arteriyel parsiyel oksijen basıncı ve oksijen saturasyonu, postoperatif ağrı varlığı ve kısa uyku süresi deliryum için risk faktörleridir.

Keywords

• karotis stenozu
• deliryum
• endarterektomi

Frequency of delirium after carotid endarterectomy

Abstract

Internal carotid artery stenosis is a consequence of systemic atherosclerotic disease. Internal carotid artery endarterectomy is a treatment method used to prevent life-threatening strokes in patients with severe internal carotid artery stenosis. Delirium may occur in patients after carotid endarterectomy due to hemodynamic changes due to cerebral perfusion deficiency. This study was conducted to determine the frequency and risk factors of delirium in patients who undergoing carotid endarterectomy. The research was a descriptive and cross-sectional prospective study. Research data were collected in 2 years and 83 patients who agreed to participate in the study were reached. Sociodemographic and clinical characteristics data collection form, intensive care delirium screening checklist, and pain scale were used. Delirium was detected in 2.07% of the patients after carotid endarterectomy. The mean oxygen saturation values of the patients with and without delirium in the 2-4 hours after carotid endarterectomy were found to be a statistically significant difference (p<0.05). After carotid endarterectomy oxygen saturation means of the patients who developed delirium was lower than the other patients in the 2-4 hours postoperatively. In patients who sleep 4 hours or more, delirium was less common than other patients. It was found that the means pain scores of patients who developed and did not develop delirium on the 1st postoperative day were statistically significant (p<0.05) In conclusion, after internal carotid artery endarterectomy, advanced age, low arterial partial oxygen pressure and oxygen saturation, presence of postoperative pain and short sleep duration are risk factors for delirium.

Keywords

• carotid stenosis
• delirium
• endarterectomy

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