*Corresponding Authors:
Yanqing Wang , MD, Department of Cardiology, Jinling Hospital,
Medical School of Nanjing University, Nanjing 210000, Jiangsu, China
Email: drwangyanqing@aliyun.com
Disclosure: The authors declare no potential conflicts exist.
Sources of funding: This work was supported by the National
Nature Science Foundation of China (NO. 81700296 and NO. 81670299).
Objective To determine the predictive value of surgical Apgar
score on delirium postoperatively following OPCABG.
Method Medical records and intraoperative anesthesia data of
all patients underwent OPCABG during the period of January 2012 and
December 2019 were reviewed and SAS score of each patient was
calculated. Relationship between SAS score and postoperative occurrence
of delirium were analyzed to determine the underlying mechanism.
Results There are a total of 436 patients included in this
study with a mean age of 62.8±13.8 and 61.2±16.8 in each group. Patients
in Delirium group had significantly higher incidence of heart failure
(P=0.043) preoperatively in the Delirium group. No significant
difference was observed referring to ASA PS III (P=0.102) and no
significant difference was observed in duration of the surgery and
anesthesia. Also no significant differences was observed as to
dexmedetomidine and propofol use (P=0.256, P=0.278). The mean SAS score
was in 4.2±0.8, 7.8±1.2 in two groups respectively (P<0.001) and
96(22.02%) postoperative delirium events were recorded. Patients in
Delirium group had much more EBL (P<0.001) while LHR (P=102) showed no
significant statistical difference between two groups. Univariate and
multivariate regression analysis showed that the intraoperative SAS
score was significant predictors of delirium following OPCABG (P<0.001;
P<0.001). After adjustment for other clinical predictors, the addition
of SAS also improved and the area under the curve to predict delirium
was 0.934 (95%CI, 0.907-0.960, P<0.001).
Conclusions Intraoperative SAS score is associated with
postoperatively following OPCABG and SAS score may be a valuable
component to improve preoperative risk stratification and discrimination
of delirium among patient under OPCABG.
Keywords Off-pump coronary artery bypass grafting; Surgical
Apgar Score; Delirium; Postoperative; Prediction