Incidence And Risk Factors For Postictal Delirium In Patients After Electroconvulsive Therapy In China

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 Affiliated 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, Chi-squared 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 first ECT session. Patients receiving ECT for the first time (P = 0.016), agitation before the ECT (P = 0.028), and high heart rate variances (P = 0.044) were identified as risk factors for PID, and they were significantly correlated with the occurrence of moderate to severe PID (P < 0.01). Conclusion: The patients receiving ECT for the first 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 benefit from detailed knowledge about the aforementioned risk factors for predicting PID and to anticipate the best possible management for these patients.