Analysis of risk factors for emergence delirium after tonsillectomy/adenoidectomy in preschool children
Objective To analyze the risk factors of emergence delirium in children after tonsillectomy/adenoidectomy.Methods A total of 94 children who underwent tonsillectomy/adenoidectomy at Ningxia Medical University General Hospital from No-vember 2022 to September 2023 were selected and divided into a delirium group(n=19)and a non-delirium group(n=75)according to whether postoperative delirium occurred during the recovery period.Comparing the general information and preoperative laboratory pa-rameters of the two groups of patients,variables with statistically significant differences between the groups[age,lymphocyte count,neu-trophils/lymphocytes,monocytes/lymphocytes,modified Yale Preoperative Anxiety Scale(mYPAS)score,postoperative Pain Behavior Quantification Scale for Children(FLACC)score]were subjected to single-factor logistic regression analysis,and variables with P＜0.05 in the single-factor logistic regression analysis were included in the multi-factor logistic regression analysis.Analysis of independent risk factors for emergence delirium in children undergoing tonsillectomy/adenoidectomy.Results Nineteen out of 94 children(25.3％)developed emergence delirium.The age of the children in the delirium group was lower than that of the non-delirium group,the proportion of mYPAS score and postoperative FLACC score＞4 points was higher than that of the non-delirium group,the preoperative lymphocyte count was higher than that of the non-delirium group,and the preoperative neutrophil/lymphocyte count was higher than that of the non-delirium group.The numbers of neutrophils/lymphocytes and monocytes/lymphocytes in the blood of patients in the de-lirium group are lower than those numbers in patients in the non-delirium group(all P＜0.05).There were no statistically significant dif-ferences in other general information and preoperative laboratory parameters(all P＞0.05).The results of single-factor logistic regression analysis showed that young age[odds ratio(OR)0.66(95％confidence interval(CI)0.445,0.991),P＜0.05]and high lymphocyte count[OR 1.57(95％CI 1.026,2.402),P＜0.05],high mYPAS score[OR 1.03(95％CI 1.004,1.057),P＜0.05],and postoperative FLACC score＞4 points[OR 5.95(95％CI 1.797,19.687),P＜0.05]are tonsil/Risk factors for emergence delirium in children undergoing adenoidecto-my.Multivariate logistic regression analysis showed that postoperative FLACC score＞4 points[OR 5.32(95％CI 1.470,19.232),P＜0.05]is an independent risk factor for emergence delirium in children undergoing tonsillectomy/adenoidectomy.Conclusions The incidence of emerging delirium in children who underwent tonsillectomy/adenoidectomy was 25.3％.FLACC score＞4 is an independent risk factor for emergence delirium in children undergoing tonsillectomy/adenoidectomy.
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