Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2021; 9(22): 6319-6328
Published online Aug 6, 2021. doi: 10.12998/wjcc.v9.i22.6319
Analysis of sleep characteristics and clinical outcomes of 139 adult patients with infective endocarditis after surgery
Xiang-Ming Hu, Cai-Di Lin, De-Yi Huang, Xiao-Ming Li, Fen Lu, Wen-Ting Wei, Zhi-Hong Yu, Huo-Sheng Liao, Fang Huang, Xue-Zhen Huang, Fu-Jun Jia
Xiang-Ming Hu, Fu-Jun Jia, The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, Guangdong Province, China
Xiang-Ming Hu, Cai-Di Lin, De-Yi Huang, Xiao-Ming Li, Fen Lu, Wen-Ting Wei, Zhi-Hong Yu, Huo-Sheng Liao, Fang Huang, Xue-Zhen Huang, Department of Comprehensive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China
Fu-Jun Jia, Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China
Author contributions: All authors contributed to this study; material preparation, data collection, and analysis were performed by Hu XM, Lin CD, Huang DY, Li XM, Lu F, Wei WT, Yu ZH, Liao HS, Huang F, and Huang XZ; the draft of the manuscript was written by Hu XM and Jia FJ; all authors have read and approved the final manuscript.
Supported by Science and Technology Planning Project of Guangdong Province, No. A2016057.
Institutional review board statement: This study was approved by the Ethics Committee of the Guangdong Provincial People's Hospital (No. GDREC2016222H (R2)). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent statement: Due to the retrospective nature of this study, the requirement for informed consent was waived.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: The datasets generated and analyzed during the present study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement – Checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – Checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fu-Jun Jia, MD, Director, Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 123 Huifu Road, Yuexiu District, Guangzhou 510080, Guangdong Province, China. jiafujun@126.com
Received: February 17, 2021
Peer-review started: February 17, 2021
First decision: April 24, 2021
Revised: June 3, 2021
Accepted: June 22, 2021
Article in press: June 22, 2021
Published online: August 6, 2021
Processing time: 160 Days and 12.4 Hours
Abstract
BACKGROUND

Little is known about the postoperative sleep quality of infective endocarditis patients during hospitalization and after discharge.

AIM

To investigate the sleep characteristics of infective endocarditis patients and to identify potential risk factors for disturbed sleep quality after surgery.

METHODS

The Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale were used to assess patient sleep quality. Logistic regression was used to explore the potential risk factors.

RESULTS

The study population (n = 139) had an average age of 43.40 ± 14.56 years, and 67.6% were men (n = 94). Disturbed sleep quality was observed in 86 patients (61.9%) during hospitalization and remained in 46 patients (33.1%) at 6 mo after surgery. However, both PSQI and Epworth Sleepiness Scale scores showed significant improvements at 6 mo (P < 0.001 and P = 0.001, respectively). Multivariable logistic regression analysis showed that the potential risk factors were age (odds ratio = 1.125, 95% confidence interval: 1.068-1.186) and PSQI assessed during hospitalization (odds ratio = 1.759, 95% confidence interval: 1.436-2.155). The same analysis in patients with PSQI ≥ 8 during hospitalization suggested that not using sleep medication (odds ratio = 15.893, 95% confidence interval: 2.385-105.889) may be another risk factor.

CONCLUSION

The incidence of disturbed sleep after infective endocarditis surgery is high. However, the situation improves significantly over time. Age and early postoperative high PSQI score are risk factors for disturbed sleep quality at 6 mo after surgery.

Keywords: Infective endocarditis; Sleep quality; Pittsburgh sleep quality index; Epworth sleepiness scale; Surgery

Core Tip: The current study is thus far the first to investigate the sleep quality of infective endocarditis patients after surgery. The Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale were employed for the assessment. Data were collected during hospitalization and at 6 mo after surgery. Disturbed sleep quality was reported by 61.9% of patients during hospitalization and 33.1% of patients at 6 mo after surgery. The patients’ sleep quality improved significantly over time. Age and high scores in Pittsburgh Sleep Quality Index assessed during hospitalization may be risk factors for disturbed sleep at 6 mo after surgery.