Association Between Glucose Variability And Postoperative Delirium In Acute Aortic Dissection Patients: An Observational Study

Abstract

Background: Blood glucose variability is associated with poor prognosis after cardiac surgery, but the relationship between glucose variability and postoperative delirium in patients with acute aortic dissection is unclear. The study aims to investigate the association of blood glucose variability with postoperative delirium in acute aortic dissection patients.Methods: We prospectively analyzed 257 patients including 103 patients with delirium. The patients were divided into two groups according to whether delirium was present. The outcome measures were postoperative delirium, the length of the Intensive Care Unit stay, and the duration of hospital stay. Multivariable Cox competing risk survival models was used to assess.Results: A total of 257 subjects were enrolled, including 103 patients with delirium. There were statistically significant differences between the two groups in age, body mass index, first admission blood glucose, white blood cell counts, Acute Physiology and Chronic Health Evaluation II score, hypoxemia, mechanical ventilation duration, and the length of Intensive Care Unit stay (P<0.05). The median of the mean of blood glucose and the standard deviation of blood glucose were higher in the delirium group than in the non-delirium group, and the difference was statistically significant (P<0.05). In model 1, the adjusted hazard ratio of the standard deviation of blood glucose was 1.436 (P<0.05). In Model 2, the standard deviation of blood glucose (AHR=1.418, 95% CI=1.195-1.681, P<0.05) remained significant after adjusting for confounders (P<0.05). The area under the curve of the standard deviation of blood glucose was 0.763 (95% CI=0.704-0.821, P<0.01). The sensitivity was 81.6%, and the specificity was 57.8%. Conclusions: Glucose variability is associated with the risk of delirium in patients after aortic dissection surgery, and high glycemic variability increases the risk of postoperative delirium.

WITHDRAWN: Prognostic Impact of the Metabolic Syndrome and Its Components in Acute Type A Aortic Dissection After Surgery: A 3-Year Follow-Up

“…In a clinical observational study, T2DM reduced the clinical complications and mortality in Stanford type B aortic dissection after thoracic endovascular aortic repair during 3-year follow up [18]. While, Lin YJ et al were found that glucose variability was associated with the incidence of postoperative delirium in acute aortic dissection patients [19]. For T2DM, there was not signi cant difference between two groups in our study.…”

Incidence and risk factors of delirium in post-anaesthesia care unit

“…Preoperative HbA1C and random blood glucose were associated with PACU delirium in our study. Lin et al similarly found that high glycaemic variability increases the risk of PACU delirium in acute aortic dissection patients, 23 while Heymann et al also found that patients with hyperactive delirium had higher mean blood glucose than the non-hyperactive delirium patients. 24 As a simple carbohydrate, the effect of glucose on the body is significant.…”

Admission Hyperglycemia in Acute Type A Aortic Dissection Predicts for a Prolonged Duration of Mechanical Ventilation

“…AAAD is a clinical emergency, in which the pathophysiological change results in inducing intensive stress responses that can cause damage to the stability of the body's intracellular environment and finally to glycometabolism disorders of patients. 11) Our previous study 12) uncovered that high glycemic variability increases the risk of postoperative delirium. However, the influence of admission hyperglycemia on patients with AAAD has not yet been reported.…”