Predicting postoperative delirium after percutaneous transluminal angioplasty and stenting in patients with intracranial atherosclerotic stenosis

ABSTRACT

Objective

Known as a major surgical complication, postoperative delirium (POD) has not been well studied in patients with intracranial atherosclerotic stenosis (ICAS). This study aimed to investigate the correlation between perioperative clinical characteristics and the occurrence of POD.

Methods

Patients’ demographic characteristics and perioperative testing data were collected. Binary logistic regression was conducted for assessing related risk factors. A nomogram was developed to predict the occurrence of POD after percutaneous transluminal angioplasty and stenting (PTAS) in patients with ICAS.

Results

The occurrence of POD in this study was 30.67%. Among all the clinical and laboratory characteristics in patients, age (OR = 1.234, 95%CI = 1.004–1.517, p = 0.046), gender (OR = 5.676, 95%CI = 1.028–31.334, p = 0.046), preoperative MMSE scores (OR = 2.298, 95%CI = 1.005–5.259, p = 0.049), the degree of stenosis (OR = 6.294, 95%CI = 1.043–37.974, p = 0.045), operating time (OR = 1.088, 95%CI = 1.023–1.157, p = 0.006), and HbA1c levels (OR = 2.226, 95%CI = 1.199–4.130, p = 0.011) were the independent risk factors.

Conclusion

Male patients with advanced-age, lower preoperative MMSE scores, severe stenosis, longer operating time, and higher HbA1c levels are closely related to POD after PTAS. Fully perioperative assessments may play an important role in predicting the occurrence of POD.

KEYWORDS:

• Postoperative delirium
• intracranial atherosclerotic stenosis
• percutaneous transluminal angioplasty and stenting
• independent risk factor
• nomogram

Acknowledgments

The authors would like to thank all the individuals who offered help and advice on this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethic committee of Shanghai Jiaotong University School of Medicine Xinhua Hospital and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Additional information

Funding

This study was supported by Shanghai Science and Technology Committee (Grant No.XHKJ200170) and National Natural Science Foundation of China (Grant No.82171360).