Incidence and risk factors for postictal delirium in patients after electroconvulsive therapy in China

Abstract

Aim: This study aimed to elucidate the incidence and risk factors for postictal delirium (PID) among Chinese patients undergoing electroconvulsive therapy (ECT). Methods: In this retrospective study, 203 patients who underwent ECT in the Third A liated Hospital of Sun Yat-Sen University from July 2016 to July 2017 had their PID severity measured by a previously developed scale. For data analysis, two groups were created: PID patients and non-PID patients. The groups were analyzed based on three types of independent variables: patient-related, electroconvulsive treatment, and hemodynamic variables. Data analysis was performed through descriptive statistics, Chisquared tests, Fisher exact tests, and/or independent sampled t-tests. Logistic regression analysis was used to identify independent risk factors for postictal delirium (P < 0.05). Results: Results showed that 81 patients (39.9%) developed moderate to severe PID in their rst ECT session. Patients receiving ECT for the rst time (P = 0.016), agitation before the ECT (P = 0.028), and high heart rate variances (P = 0.044) were identi ed as risk factors for PID, and they were signi cantly correlated with the occurrence of moderate to severe PID (P < 0.01). Conclusion: The patients receiving ECT for the rst time, with agitation states before ECT and/or with high heart rate variance during ECT procedures might be at higher risk for moderate to severe PID. The medical staff related to this type of treatment may bene t from detailed knowledge about the aforementioned risk factors for predicting PID and to anticipate the best possible management for these patients.