The Long-Term Cognitive and Functional Outcomes of Postoperative Delirium After Cardiac Surgery

2009 ◽  
Vol 87 (5) ◽  
pp. 1469-1474 ◽  
Author(s):  
Sandra Koster ◽  
Ab G. Hensens ◽  
Job van der Palen
BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e032935
Author(s):  
Joanna S Semrau ◽  
Stephen H Scott ◽  
Andrew G Hamilton ◽  
Dimitri Petsikas ◽  
Darrin M Payne ◽  
...  

IntroductionPatients undergoing cardiac surgery may experience both short-term and long-term postoperative neurological problems. However, the underlying cause of this impairment is unclear. Regional cerebral oxygen saturation (rSO2) levels may play a role in the development of acute dysfunction, known as postoperative delirium, in addition to longer term outcomes after cardiac surgery. Yet the degree of impairment has been difficult to define, partly due to subjective methods of assessments. This study aims to fill this knowledge gap by determining the relationship between rSO2, postoperative delirium and long-term neurological outcome after cardiac surgery using quantitative robotic technology.Methods and analysis95 patients scheduled for elective cardiac surgery will be recruited for this single-centre prospective observational study. Patients will be assessed before as well as 3 and 12 months after their surgery using the Kinarm End-Point Lab and standardised tasks. Intraoperatively, rSO2 and other haemodynamic data will be collected for the duration of the procedure. Following their operation, patients will also be screened daily for delirium during their hospital stay.Ethics and disseminationThis study has been approved by the Health Sciences Research Ethics Board at Queen’s University (DMED-1672–14). The results of this study will be published in a peer-review journal and presented at international and/or national conferences as poster or oral presentations. Participants wishing to know the results of this study will be contacted directly on data publication.Trial registration numberNCT04081649


2009 ◽  
Vol 12 (2-3) ◽  
pp. 54-57 ◽  
Author(s):  
Nnamdi Nwaejike ◽  
Niall Breen ◽  
Pramod Bonde ◽  
Gianfranco Campalani

Medicina ◽  
2020 ◽  
Vol 56 (6) ◽  
pp. 258
Author(s):  
Thomas Saller ◽  
Sven Peterss ◽  
Patrick Scheiermann ◽  
Daniela Eser-Valeri ◽  
Johannes Ehler ◽  
...  

Background and Objectives: Delirium is a common and major complication subsequent to cardiac surgery. Despite scientific efforts, there are no parameters which reliably predict postoperative delirium. In delirium pathology, natriuretic peptides (NPs) interfere with the blood–brain barrier and thus promote delirium. Therefore, we aimed to assess whether NPs may predict postoperative delirium and long-term outcomes. Materials and Methods: To evaluate the predictive value of NPs for delirium we retrospectively analyzed data from a prospective, randomized study for serum levels of atrial natriuretic peptide (ANP) and the precursor of C-type natriuretic peptide (NT-proCNP) in patients undergoing coronary artery bypass grafting (CABG) with or without cardiopulmonary bypass (off-pump coronary bypass grafting; OPCAB). Delirium was assessed by a validated chart-based method. Long-term outcomes were assessed 10 years after surgery by a telephone interview. Results: The overall incidence of delirium in the total cohort was 48% regardless of the surgical approach (CABG vs. OPCAB). Serum ANP levels > 64.6 pg/mL predicted delirium with a sensitivity (95% confidence interval) of 100% (75.3–100) and specificity of 42.9% (17.7–71.1). Serum NT-proCNP levels >1.7 pg/mL predicted delirium with a sensitivity (95% confidence interval) of 92.3% (64.0–99.8) and specificity of 42.9% (17.7–71.1). Both NPs could not predict postoperative survival or long-term cognitive decline. Conclusions: We found a positive correlation between delirium and preoperative plasma levels of ANP and NT-proCNP. A well-powered and prospective study might identify NPs as biomarkers indicating the risk of delirium and postoperative cognitive decline in patients at risk for postoperative delirium.


Author(s):  
James A. Brown ◽  
Arman Kilic ◽  
Edgar Aranda-Michel ◽  
Forozan Navid ◽  
Derek Serna-Gallegos ◽  
...  

2013 ◽  
Vol 61 (S 01) ◽  
Author(s):  
C Schimmer ◽  
K Hamouda ◽  
M Özkur ◽  
SP Sommer ◽  
I Aleksic ◽  
...  

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