scholarly journals Incidence and Risk Factors of Early Delirium after Cardiac Surgery

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Ieva Norkienė ◽  
Donata Ringaitienė ◽  
Vilma Kuzminskaitė ◽  
Jūratė Šipylaitė
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Intensive Care Unit Stay ◽  
Postoperative Delirium ◽  
Group Versus ◽  
University Hospital ◽  
Low Cardiac Output Syndrome ◽  
Duration Of Surgery

Introduction. The aim of our study was to identify the incidence and risk factors of delirium after cardiac surgery implementing Intensive Care Delirium Screening Checklist (ICDSC).Material and Methods. 87 patients, undergoing cardiac surgery at Vilnius University hospital, were prospectively monitored for postoperative delirium development, during intensive care unit stay.Results. The incidence of postoperative delirium was 13.30%. No statistically relevant preoperative predictors of delirium were found. The duration of surgery was significantly longer in delirium group ( versus hours, ). Patients in delirium group more often had blood product transfusions (1.50 (± 1.57) versus 0.49 (± 0.91) ) and had a higher incidence of low cardiac output syndrome (33.30% versus 3.00%, ); they were significantly longer mechanically ventilated ( versus 8.78 ± 4.77 ()) hours (OR = 1.15 ()) and had twice longer ICU stay ( versus 2.60 ± 1.10 ()) days (OR = 1.91 ()).Conclusions. The incidence of delirium after cardiac surgery was 13.3%. Independent predictors of delirium were duration of postoperative mechanical ventilation and intensive care unit stay.

Interacting risk factors determine the outcome of patients with a prolonged intensive care unit stay after cardiac surgery

2013 ◽  
Vol 61 (S 01) ◽  
Author(s):  
J Schöttler ◽  
C Grothusen ◽  
T Attmann ◽  
C Friedrich ◽  
S Freitag-Wolf ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Intensive Care Unit Stay

scholarly journals Association between glucose variability and postoperative delirium in acute aortic dissection patients: an observational study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yan-Juan Lin ◽  
Ling-Yu Lin ◽  
Yan-Chun Peng ◽  
Hao-Ruo Zhang ◽  
Liang-wan Chen ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Blood Glucose ◽  
Standard Deviation ◽  
Aortic Dissection ◽  
Intensive Care Unit Stay ◽  
Postoperative Delirium ◽  
Acute Aortic Dissection ◽  
Glucose Variability

Abstract Background Blood glucose variability is associated with poor prognosis after cardiac surgery, but the relationship between glucose variability and postoperative delirium in patients with acute aortic dissection is unclear. The study aims to investigate the association of blood glucose variability with postoperative delirium in acute aortic dissection patients. Methods We prospectively analyzed 257 patients including 103 patients with delirium. The patients were divided into two groups according to whether delirium was present. The outcome measures were postoperative delirium, the length of the Intensive Care Unit stay, and the duration of hospital stay. Multivariable Cox competing risk survival models was used to assess. Results A total of 257 subjects were enrolled, including 103 patients with delirium. There were statistically significant differences between the two groups in body mass index, history of cardiac surgery, first admission blood glucose, white blood cell counts, Acute Physiology and Chronic Health Evaluation II score, hypoxemia, mechanical ventilation duration, and the length of Intensive Care Unit stay(P < 0.05). The delirium group exhibited significantly higher values of the mean of blood glucose (MBG) and the standard deviation of blood glucose (SDBG) than in the non-delirium group(P < 0.05). In model 1, the adjusted hazard ratio (AHR) of the standard deviation of blood glucose was 1.436(P < 0.05). In Model 2, the standard deviation of blood glucose (AHR = 1.418, 95%CI = 1.195–1.681, P < 0.05) remained significant after adjusting for confounders. The area under the curve of the SDBG was 0.763(95%CI = 0.704–0.821, P < 0.01). The sensitivity was 81.6%, and the specificity was 57.8%. Conclusions Glucose variability is associated with the risk of delirium in patients after aortic dissection surgery, and high glycemic variability increases the risk of postoperative delirium.

Prolonged Intensive Care Unit Stay in Cardiac Surgery: Risk Factors and Long-Term-Survival

2006 ◽  
Vol 81 (3) ◽  
pp. 880-885 ◽  
Author(s):  
Ortrud Vargas Hein ◽  
Jürgen Birnbaum ◽  
Klaus Wernecke ◽  
Michael England ◽  
Wolfgang Konertz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Intensive Care Unit Stay ◽  
Term Survival ◽  
Long Term Survival

scholarly journals Prevalence of postoperative delirium according to the intraoperative general anesthetic agents in patients undergoing cardiac surgery: A retrospective and propensity-score matched study

2020 ◽  
Author(s):  
Hyun-Jung Shin ◽  
Soo Lyoen Choi ◽  
Hyo-Seok Na
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Postoperative Delirium ◽  
Bypass Graft ◽  
Significant Risk ◽  
Anesthetic Agents

Abstract Background: Postoperative delirium (PD) is still an issue in post-cardiac surgery patients despite the constant efforts to reduce it. Although various risk factors for PD after cardiac surgery have been identified, there is limited clinical data regarding the effect of intraoperative anesthetic agents on the PD.Methods: The medical records of 534 patients, who had undergone heart valve surgery or coronary artery bypass graft surgery with cardiopulmonary bypass (CPB) between January 2012 and August 2017, were investigated. They were divided into two groups according to the main anesthetic agent: sevoflurane with dexmedetomidine (sevo-dex group, n = 340) and propofol (propofol group, n = 194). The incidence of PD was evaluated as the primary outcome. PD was defined as the positive Confusion Assessment Method for the Intensive Care Unit during the intensive care unit stay. Patient-, surgery-, and anesthesia-related factors and postoperative complications were investigated as secondary outcomes. To reduce the risk of confounder effects between the two groups, 194 patients were selected from the sevo-dex group after propensity-score matching.Results: After propensity-score matching, the incidence of PD was not significantly different between the sevo-dex (6.2%) and propofol (10.8%) groups (P = 0.136). In comparison of the incidence of each type of PD, only hyperactive PD occurred significantly less in the sevo-dex group than in the propofol group (P = 0.021). Older age, lower preoperative albumin levels, and emergency surgery were significant risk factors for PD.Conclusions: The overall incidence of PD after cardiac surgery with CPB is not associated with the main anesthetic agents, sevoflurane and dexmedetomidine-based vs. propofol-based anesthesia. Only hyperactive PD occurred less frequently after in patients receiving sevoflurane and dexmedetomidine-based anesthesia.

Risk factors for long intensive care unit stay after cardiac surgery. A multivariate analysis

2012 ◽  
Vol 29 ◽  
pp. 187-188
Author(s):  
A. Candela-Toha ◽  
B. Prada ◽  
P. Arribas ◽  
E. Elias-Martin ◽  
A. de Pablo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Multivariate Analysis ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Intensive Care Unit Stay

Prevalence and Risk Factors for Postoperative Delirium in a Cardiovascular Intensive Care Unit

2008 ◽  
Vol 17 (6) ◽  
pp. 567-575 ◽  
Author(s):  
Yu-Ling Chang ◽  
Yun-Fang Tsai ◽  
Pyng-Jing Lin ◽  
Min-Chi Chen ◽  
Chia-Yih Liu
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Postoperative Delirium ◽  
Acute Infection ◽  
Univariate Analysis ◽  
Open Heart Surgery ◽  
Chang Gung Memorial Hospital ◽  
Cardiovascular Intensive Care

Background Delirium after cardiac surgery is a common complication in cardiovascular intensive care units. The prevalence of delirium and its likely risk factors have not previously been explored in a single sample of postoperative cardiac patients in an intensive care unit. Objective To compare a variety of characteristics in patients with and without delirium and to identify risk factors associated with delirium in patients hospitalized in an intensive care unit after cardiac surgery. Methods A retrospective chart review was used to collect data on 288 patients who had open heart surgery during the period 2004 to 2005 at Chang Gung Memorial Hospital in northern Taiwan. A researcher-designed checklist of 52 patient-related risk factors for delirium was used to collect preoperative, intra-operative, and postoperative data. All patients were assessed by psychiatrists, and delirium was diagnosed according to criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. Data were analyzed via univariate analysis and multivariate logistic regression. Results The prevalence of postoperative delirium was 41.7%. Patients with and without delirium differed significantly on 29 variables. Four postoperative factors, hematocrit less than 30%, cardiogenic shock, hypoalbuminemia, and acute infection, were significant, independent predictors of postoperative delirium. Conclusions The results of this study can be used to develop a revised checklist of 29 preoperative, intraoperative, and postoperative risk factors for delirium, with special attention to the 4 predictive postoperative factors. Use of such a checklist may facilitate the ability to prevent or detect delirium early and provide suitable treatment.

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