Risk factors for mortality in patients undergoing continuous renal replacement therapy after cardiac surgery

Abstract Background To investigate the risk factors for mortality in patients with acute kidney injury requiring continuous renal replacement therapy (AKI-CRRT) after cardiac surgery. Methods In this retrospective study, patients who underwent AKI-CRRT after cardiac surgery in our centre from January 2015 to January 2020 were included. Univariable and multivariable analyses were performed to identify the risk factors for in-hospital mortality. Results A total of 412 patients were included in our study. Of these, 174 died after AKI-CRRT, and the remaining 238 were included in the survival control group. Multivariable logistic regression analysis revealed that EuroSCORE > 7 (odds ratio [OR], 3.72; 95% confidence interval [CI], 1.92–7.24; p < 0.01), intraoperative bleeding > 1 L (OR, 2.14; 95% CI, 1.19–3.86; p = 0.01) and mechanical ventilation time > 70 h (OR, 5.03; 95% CI, 2.40–10.54; p < 0.01) were independent risk factors for in-hospital mortality in patients who had undergone AKI-CRRT. Our study also found that the use of furosemide after surgery was a protective factor for such patients (odds ratio, 0.48; 95% confidence interval, 0.25–0.92; p = 0.03). Conclusions In summary, the mortality of patients with AKI-CRRT after cardiac surgery remains high. The EuroSCORE, intraoperative bleeding and mechanical ventilation time were independent risk factors for in-hospital mortality. Continuous application of furosemide may be associated with a better outcome.

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Perioperative complications in a paediatric cardiac surgery program with limited systemic resources

Cardiology in the Young ◽

10.1017/s1047951120002486 ◽

2020 ◽

Vol 30 (11) ◽

pp. 1659-1665

Author(s):

Igor V. Polivenok ◽

William M. Novick ◽

Aleksander V. Pyetkov ◽

Marcelo Cardarelli

Keyword(s):

Risk Factors ◽

Cardiac Surgery ◽

Confidence Interval ◽

Odds Ratio ◽

Operative Mortality ◽

Perioperative Complications ◽

Failure To Rescue ◽

Middle Income ◽

Paediatric Cardiac Surgery ◽

Complications Rate

AbstractBackground:The perioperative complications rate in paediatric cardiac surgery, as well as the failure-to-rescue impact, is less known in low- and middle-income countries.Aim:To evaluate perioperative complications rate, mortality related to complications, different patients’ demographics, and procedural risk factors for perioperative complication and post-operative death.Methods:Risk factors for perioperative complications and operative mortality were assessed in a retrospective single-centre study which included 296 consecutive children undergoing cardiac surgery.Results:Overall mortality was 5.7%. Seventy-three patients (24.7%) developed 145 perioperative complications and had 17 operative mortalities (23.3%). There was a strong association between the number of perioperative complications and mortality – 8.1% among patients with only 1 perioperative complication, 35.3% – with 2 perioperative complications, and 42.1% – with 3 or more perioperative complications (p = 0.007). Risk factors of perioperative complications were younger age (odds ratio 0.76; (95% confidence interval 0.61, 0.93), previous cardiac surgery (odds ratio 3.5; confidence interval 1.33, 9.20), extracardiac structural anomalies (odds ratio 3.03; confidence interval 1.27, 7.26), concomitant diseases (odds ratio 3.23; confidence interval 1.34, 7.72), and cardiopulmonary bypass (odds ratio 6.33; confidence interval 2.45, 16.4), whereas the total number of perioperative complications per patient was the only predictor of operative death (odds ratio 1.89; confidence interval 1.06, 3.37).Conclusions:In a program with limited systemic resources, failure-to-rescue is a major contributor to operative mortality in paediatric cardiac surgery. Despite the comparable crude mortality, the operative mortality among patients with perioperative complications in our series was significantly higher than in the developed world. A number of initiatives are needed in order to improve failure-to-rescue rates in low- and middle-income countries.

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Risk Factors for the Development of Nosocomial Pneumonia and Its Clinical Impact in Cardiac Surgery

10.21203/rs.3.rs-882631/v1 ◽

2021 ◽

Author(s):

Ferdinand Jr Rivera Gerod ◽

Edgar Ongjoco ◽

Rod Castro ◽

Armin Masbang ◽

Elmer Casley Repotente ◽

...

Keyword(s):

Risk Factors ◽

Mechanical Ventilation ◽

Cardiac Surgery ◽

Hospital Mortality ◽

Nosocomial Pneumonia ◽

Clinical Impact ◽

Adult Patients ◽

Mortality And Morbidity ◽

Factors Associated ◽

Prolonged Icu Stay

Abstract BackgroundThe development of nosocomial pneumonia after cardiac surgery is a significant post-operative complication that may lead to increased morbidity, mortality, and hospital cost. We aimed to identify risk factors associated with it and to determine its clinical impact in terms of in-hospital mortality and morbidity.MethodsThis is a retrospective cohort study conducted among all adult patients who underwent cardiac surgery from 2014-2019 in St. Luke’s Medical Center, Quezon City, Philippines. Baseline characteristics and possible risk factors for pneumonia were retrieved from medical records. Nosocomial pneumonia was based on the Centers for Disease Control and Prevention criteria. Clinical outcomes include in-hospital mortality and morbidity. Odds ratios from logistic regression was computed to determine risk factors associated with pneumonia using STATA 15.0.ResultsOut of 373 patients included in this study, 104 (28%) patients acquired pneumonia. Most surgeries were coronary artery bypass graft (CABG) (71.58%), followed by valve repair/replacement (29.76%). Neither age, sex, BMI, diabetes, LV dysfunction, renal dysfunction, COPD/asthma, urgency of surgery, surgical time, nor smoking showed association in the development of pneumonia. However, preoperative stay of >2 days was associated with 92.3% (95%CI 18–213%) increased odds of having pneumonia (p=.009). Also, every additional hour on mechanical ventilation conferred 0.8% (95%CI, 0.3–1%) greater odds of acquiring pneumonia (p=.003).Patients who developed pneumonia had 3.9 times odds of mortality (95%CI 1.51–9.89, p=.005), 3.8 times odds of prolonged hospitalization (95%CI 1.81–7.90,p<.001), 6.4 times odds of prolonged ICU stay (95%CI 3.59–11.35,p<.001), and 9.5 times odds of postoperative reintubation (95%CI 3.01–29.76,p<.001). ConclusionAmong adult patients undergoing cardiac surgeries, prolonged preoperative hospital stay and prolonged mechanical ventilation were both associated with an increased risk for nosocomial pneumonia. Those who developed pneumonia had worse outcomes with significantly increased in-hospital mortality, prolonged hospitalization, prolonged ICU stay, and increased postoperative re-intubation. Clinicians should therefore minimize delays in surgery to avoid unnecessary exposure to pathogenic organisms. Also, timely liberation from mechanical ventilation after surgery should be encouraged.

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62. Association Between Influenza Co-infection and Poor Outcomes in Patients Hospitalized with COVID-19

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.372 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S163-S163

Author(s):

Renato G Bobadilla ◽

Carlos Flores ◽

Garry Francis ◽

Victoria Bengualid

Keyword(s):

New York ◽

Mechanical Ventilation ◽

Renal Replacement Therapy ◽

Hospital Mortality ◽

Replacement Therapy ◽

Odds Ratio ◽

P Value ◽

Chi Square ◽

Poor Outcomes ◽

Novel Coronavirus

Abstract Background In December 2019, a novel coronavirus (COVID-19) infection emerged in Wuhan, China, establishing itself as a deadly pathogen leading to an ongoing pandemic. The incidence of co-infection of COVID-19 and Influenza has not been widely reported. Both infections have been known to share similar mechanisms of transmission, however currently, there is no evidence regarding the relationship between co-infection between this viruses and worsening outcomes. Once social distancing measures are eased, and daily activities resumed, there is a possibility for a second wave of cases. Given the incidence of influenza is higher during winter, a higher co-infection rate is expected in these months. Methods In this study, the aim was to assess the association of influenza co-infection with outcomes in patients diagnosed with COVID-19 in a hospital-based case-control study in Bronx, New York. 19 patients with Influenza co-infection were found in total. 1 patient did not meet inclusion/exclusion criteria. Charts were reviewed from 18 confirmed cases of influenza and COVID-19 patients. Controls were selected from the remaining pool of patients with COVID-19 in the same period. Cases were matched for age, sex and underlying comorbidities (Hypertension, Diabetes Mellitus, liver disease, cardiovascular disease, HIV status, immunocompromised state other than HIV). The measured outcomes were: in-hospital mortality, need for mechanical ventilation, need for vasopressors and need for renal replacement therapy. For each outcome, Chi Square test and Odds ratio were obtained. Results After statistical analysis, no significative difference was found in the following variables: in-hospital mortality [Odds ratio (OR) 0.769; 95% confidence interval (CI): 0.185–3.191; p value= 0.717], need for mechanical ventilation (OR 1.3; 95% CI: 0.313–5.393; p value= 0.717), need for vasopressors (OR 1.923; 95% CI: 0.383–9.646; p value= 0.423), need for renal replacement therapy (OR 1.0; 95% CI: 0.208–4.814; p value= 1.0). Conclusion There was no difference in the outcome in COVID-19 patients co-infected with influenza compared to non co-infected patients, however, a larger sample of cases will be needed for further assessment of these outcomes. Disclosures All Authors: No reported disclosures

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Perioperative Outcomes after Unilateral and Bilateral Total Knee Arthroplasty

Anesthesiology ◽

10.1097/aln.0b013e3181bfab7d ◽

2009 ◽

Vol 111 (6) ◽

pp. 1206-1216 ◽

Cited By ~ 121

Author(s):

Stavros G. Memtsoudis ◽

Yan Ma ◽

Alejandro González Della Valle ◽

Madhu Mazumdar ◽

Licia K. Gaber-Baylis ◽

...

Keyword(s):

Confidence Interval ◽

Hospital Mortality ◽

Odds Ratio ◽

Morbidity And Mortality ◽

Perioperative Outcomes ◽

Perioperative Morbidity ◽

Increased Risk ◽

Comorbidity Burden ◽

Total Knee ◽

Independent Risk Factors

Background The safety of bilateral total knee arthroplasties (BTKAs) during the same hospitalization remains controversial. The authors sought to study differences in perioperative outcomes between unilateral and BTKA and to further compare BTKAs performed during the same versus different operations during the same hospitalization. Methods Nationwide Inpatient Sample data from 1998 to 2006 were analyzed. Entries for unilateral and BTKA procedures performed on the same day (simultaneous) and separate days (staged) during the same hospitalization were identified. Patient and healthcare system-related demographics were determined. The incidences of in-hospital mortality and procedure-related complications were estimated and compared between groups. Multivariate regression was used to identify independent risk factors for morbidity and mortality. Results Despite younger average age and lower comorbidity burden, procedure-related complications and in-hospital mortality were more frequent after BTKA than after unilateral procedures (9.45% vs. 7.07% and 0.30% vs. 0.14%; P < 0.0001 each). An increased rate of complications was associated with a staged versus simultaneous approach with no difference in mortality (10.30% vs. 9.15%; P < 0.0001 and 0.29% vs. 0.26%; P = 0.2875). Independent predictors for in-hospital mortality included BTKA (simultaneous: odds ratio, 2.23 [95% confidence interval, 1.69-2.95]; P < 0.0001; staged: odds ratio, 2.01 [confidence interval, 1.28-3.41]; P = 0.0031), male sex (odds ratio, 2.02 [confidence interval, 1.75-2.34]; P < 0.0001), age older than 75 yr (odds ratio, 3.96 [confidence interval, 2.77-5.66]; P < 0.0001), and the presence of a number of comorbidities and complications. Conclusion BTKAs carry increased risk of perioperative morbidity and mortality compared with unilateral procedures. Staging BTKA procedures during the same hospitalization offers no mortality benefit and may even expose patients to increased morbidity.

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Early Onset Pneumonia

Anesthesiology ◽

10.1097/00000542-200402000-00009 ◽

2004 ◽

Vol 100 (2) ◽

pp. 234-239 ◽

Cited By ~ 116

Author(s):

Régis Bronchard ◽

Pierre Albaladejo ◽

Gilles Brezac ◽

Arnaud Geffroy ◽

Pierre-François Seince ◽

...

Keyword(s):

Risk Factors ◽

Confidence Interval ◽

Head Trauma ◽

Early Onset ◽

Odds Ratio ◽

Nasal Carriage ◽

Arterial Oxygen ◽

Surgical Intensive Care Unit ◽

Trauma Patients ◽

Independent Risk Factors

Background Early onset pneumonia occurs frequently in head trauma patients, but the potential consequences and the risk factors of this event have been poorly studied. Methods This prospective observational study was undertaken in the surgical intensive care unit of a university teaching hospital in Clichy, France. Head trauma patients requiring tracheal intubation for neurologic reasons and ventilation for at least 2 days were studied to assess the risk factors and the consequences of early onset pneumonia. Results During a 2-yr period, 109 head trauma patients were studied. The authors found an incidence of early onset pneumonia of 41.3%. Staphylococcus aureus was the most common bacteria involved in early onset pneumonia. Patients with early onset pneumonia had a lower worst arterial oxygen tension:fraction of inspired oxygen ratio, more fever, more arterial hypotension, and more intracranial hypertension, factors known to worsen the neurologic prognosis of head trauma patients. Nasal carriage of S. aureus on admission (odds ratio, 5.1; 95% confidence interval, 1.9-14.0), aspiration before intubation (odds ratio, 5.5; 95% confidence interval, 1.9-16.4) and barbiturate use (odds ratio, 3.9; 95% confidence interval, 1.2-12.8) were found to be independent risk factors of early onset pneumonia. Conclusions The results suggest that early onset pneumonia leads to secondary injuries in head-injured patients. Nasal carriage of S. aureus, aspiration before intubation, and use of barbiturates are specific independent risk factors for early onset pneumonia and must be assessed to find and evaluate strategies to prevent early onset pneumonia.

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Influence of Erythrocyte Concentrate Storage Time on Postsurgical Morbidity in Cardiac Surgery Patients

Anesthesiology ◽

10.1097/00000542-200304000-00005 ◽

2003 ◽

Vol 98 (4) ◽

pp. 815-822 ◽

Cited By ~ 151

Author(s):

Santiago R. Leal-Noval ◽

Irene Jara-López ◽

José L. García-Garmendia ◽

Ana Marín-Niebla ◽

Angel Herruzo-Avilés ◽

...

Keyword(s):

Intensive Care Unit ◽

Mechanical Ventilation ◽

Cardiac Surgery ◽

Intensive Care ◽

Confidence Interval ◽

Prolonged Storage ◽

Prolonged Stay ◽

Ventilation Time ◽

Duration Of Storage ◽

Mechanical Ventilation Time

Background The transfusion of erythrocytes that have been stored for long periods of time can produce visceral ischemia and favor the acquisition of postsurgical infections. To estimate the role of the duration of storage of erythrocytes on morbidity in cardiac surgery, we performed an observational study. Methods All patients (n = 897) undergoing cardiac surgery during three consecutive years were included. Morbidity (main outcome measure) was evaluated by means of four surrogate measures: duration of stay in the intensive care unit longer than 4 days, mechanical ventilation time longer than 1 day, perioperative myocardial infarction rate, and severe postoperative infection rate. The mean duration of storage of all erythrocytes transfused and the duration of storage of the oldest unit transfused were used as storage variables. Results After considering multiple confounding variables related to patient severity, illness, and surgical difficulty, the duration of storage of erythrocytes was found to be associated neither with a more prolonged stay in the intensive care unit or mechanical ventilation time nor with increased rates of perioperative infarction, mediastinitis, or sepsis. However, each day of storage of the oldest unit was associated with an increment of the risk of pneumonia of 6% (95% confidence interval, 1-11; P = 0.018). The cutoff point of maximum sensitivity and specificity (54.8 and 66.9%) associated with a greater risk for pneumonia corresponded to 28 days of storage for the oldest unit (odds ratio, 2.74; 95% confidence interval, 1.18-6.36; P = 0.019). Conclusions Prolonged storage of erythrocytes does not increase morbidity in cardiac surgery. However, storage for longer than 28 days could be a risk factor for the acquisition of nosocomial pneumonia.

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Acute Renal Injury in Cardiac Surgery Patients

Russian Sklifosovsky Journal Emergency Medical Care ◽

10.23934/2223-9022-2020-9-3-383-390 ◽

2020 ◽

Vol 9 (3) ◽

pp. 383-390

Author(s):

S. I. Rey ◽

G. A. Berdnikov ◽

L. N. Zimina ◽

N. V. Rubtsov ◽

M. K. Mazanov ◽

...

Keyword(s):

Risk Factors ◽

Cardiac Surgery ◽

Renal Replacement Therapy ◽

Serum Creatinine ◽

Hospital Mortality ◽

Replacement Therapy ◽

Postoperative Period ◽

Renal Injury ◽

Acute Renal Injury ◽

Group 1

Background. Acute kidney injury following cardiac surgery remains a common and serious complication.Aim of study. To identify risk factors for the development and morphological features of acute renal injury, to assess the use of renal replacement therapy in patients after cardiac surgery.Material and methods. The study involved 66 patients who were treated in the Department of Cardiac Resuscitation of the N.V. Sklifosovsky Research Institute for Emergency Medicine from 2009 to 2018. Of these, 45 men (68.2%) and 21 women (31.8%). The mean age of the patients was 56.3±13.2 years. Clinical and anatomical analysis of material from 19 deceased patients was carried out. Depending on the use of methods of renal replacement therapy, patients were divided into two groups: Group 1 included 23 patients with acute renal injury requiring the use of renal replacement therapy; Group 2 included 43 patients where methods of renal replacement therapy were not used.Results. Hospital mortality in Group 1 was lower (34.8 and 41.9%, respectively), however, the differences were statistically insignificant (p=0.372). To identify the factors in the development of acute renal damage, a stepwise regression analysis was performed by constructing a regression model of Cox proportional hazards. Age, history of chronic kidney disease, serum creatinine level on the first day after surgery, severity of the condition according to the APACHE-II scale, increased lactate level on day 2 of the postoperative period, decreased urine output on the first day after surgery were statistically significant.Conclusion. Risk factors for the development of ARI after cardiac surgery under cardiopulmonary bypass are advanced age, CKD in history, the severity of the patient’s condition, assessed by the APACHE-II scale, increased serum creatinine on the first day after surgery, increased lactate on day 2 of the postoperative period, a decreased diuresis on day 1 after surgery. The use of RRT in patients after surgery under the conditions of AC was accompanied by a tendency to improve treatment results: in-hospital mortality in the group of patients who underwent RRT was 34.8% versus 41.9% in the group without RRT methods. Morphological and functional features of renal failure in patients with ARI were preceding chronic renal pathological processes of different etiology, mainly affecting the glomeruli, vessels and stroma, as well as acute pathological processes aggravating ARI (dyscirculatory disorder, degenerative changes, necrosis and necrobiosis tubular epithelium).

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Impact of Operative Timing in Infective Endocarditis with Cerebral Embolism—The Risk of Intermediate Deterioration

Journal of Clinical Medicine ◽

10.3390/jcm10102136 ◽

2021 ◽

Vol 10 (10) ◽

pp. 2136

Author(s):

Alexey Dashkevich ◽

Georg Bratkov ◽

Yupeng Li ◽

Dominik Joskowiak ◽

Sven Peterss ◽

...

Keyword(s):

Risk Factors ◽

Cardiac Surgery ◽

Infective Endocarditis ◽

Hospital Mortality ◽

Cerebral Embolism ◽

Time Interval ◽

Study Cohort ◽

Term Survival ◽

Entire Study ◽

Independent Risk Factors

Cerebral embolism due to infective endocarditis (IE) is associated with significant morbidity and mortality. The optimal time-interval between symptomatic stroke and cardiac surgery remains unclear. This study aimed to analyze the patients’ outcomes and define the potential risk factors with regard to surgical timing for IE patients with preoperative symptomatic cerebral embolism (CE). A total of 119 IE patients with CE were identified and analyzed with regard to operative timing: early (1–7 days), intermediate (8–21 days), and late (>22 days). The preoperative patient data, comorbidities and previous cardiac surgical procedures were analyzed to identify potential predictors and independent risk factors for in-hospital mortality using univariate and multivariate regression analysis. Actuarial survival was estimated by the Kaplan-Meier method. In-hospital mortality for the entire study cohort was 15.1% (n = 18), and in comparison, between groups was found to be highest in the intermediate surgical group (25.7%). Univariate analysis identified preoperative mechanical ventilation dependent respiratory insufficiency (p = 0.006), preoperative renal insufficiency (p = 0.019), age (p = 0.002), large vegetations (p = 0.018) as well as intermediate (p = 0.026), and late (p = 0.041) surgery as predictors of in-hospital mortality. The presence of large vegetations (>8 mm) (p = 0.019) and increased age (p = 0.037)—but not operative timing—were identified as independent risk factors for in-hospital mortality. In the presence of large vegetations (>8 mm), cardiac surgery should be performed early and independently from the entity of cerebral embolic stroke. Postponing surgery to achieve clinical stabilization and better postoperative outcomes of IE patients with CE is reasonable, however, worsening of the disease process with deterioration and resulting heart failure during the first 3 weeks after CE results in a significantly higher in-hospital mortality and inferior long-term survival.

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Incidence- and In-hospital Mortality-Related Risk Factors of Acute Kidney Injury Requiring Continuous Renal Replacement Therapy in Patients Undergoing Surgery for Acute Type a Aortic Dissection

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.749592 ◽

2021 ◽

Vol 8 ◽

Author(s):

Xuelian Chen ◽

Jiaojiao Zhou ◽

Miao Fang ◽

Jia Yang ◽

Xin Wang ◽

...

Keyword(s):

Risk Factors ◽

Renal Replacement Therapy ◽

Aortic Dissection ◽

Hospital Mortality ◽

Continuous Renal Replacement Therapy ◽

Replacement Therapy ◽

Type A ◽

Acute Type ◽

Type A Aortic Dissection ◽

Independent Risk Factors

Background: Few studies on the risk factors for postoperative continuous renal replacement therapy (CRRT) in a homogeneous population of patients with acute type A aortic dissection (AAAD). This retrospective analysis aimed to investigate the risk factors for CRRT and in-hospital mortality in the patients undergoing AAAD surgery and to discuss the perioperative comorbidities and short-term outcomes.Methods: The study collected electronic medical records and laboratory data from 432 patients undergoing surgery for AAAD between March 2009 and June 2021. All the patients were divided into CRRT and non-CRRT groups; those in the CRRT group were divided into the survivor and non-survivor groups. The univariable and multivariable analyses were used to identify the independent risk factors for CRRT and in-hospital mortality.Results: The proportion of requiring CRRT and in-hospital mortality in the patients with CRRT was 14.6 and 46.0%, respectively. Baseline serum creatinine (SCr) [odds ratio (OR), 1.006], cystatin C (OR, 1.438), lung infection (OR, 2.292), second thoracotomy (OR, 5.185), diabetes mellitus (OR, 6.868), AKI stage 2–3 (OR, 22.901) were the independent risk factors for receiving CRRT. In-hospital mortality in the CRRT group (46%) was 4.6 times higher than in the non-CRRT group (10%). In the non-survivor (n = 29) and survivor (n = 34) groups, New York Heart Association (NYHA) class III-IV (OR, 10.272, P = 0.019), lactic acidosis (OR, 10.224, P = 0.019) were the independent risk factors for in-hospital mortality in patients receiving CRRT.Conclusion: There was a high rate of CRRT requirement and high in-hospital mortality after AAAD surgery. The risk factors for CRRT and in-hospital mortality in the patients undergoing AAAD surgery were determined to help identify the high-risk patients and make appropriate clinical decisions. Further randomized controlled studies are urgently needed to establish the risk factors for CRRT and in-hospital mortality.

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Perioperative risk factors for delirium development after elective cardiovascular surgery

Patologiya krovoobrashcheniya i kardiokhirurgiya ◽

10.21688/1681-3472-2020-2-83-94 ◽

2020 ◽

Vol 24 (2) ◽

pp. 83

Author(s):

V. V. Pasyuga ◽

D. A. Demin ◽

I. L. Nudel ◽

E. V. Demina ◽

A. V. Kadykova ◽

...

Keyword(s):

Risk Factors ◽

Mechanical Ventilation ◽

Acute Kidney Injury ◽

Cardiac Surgery ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Conflict Of Interest ◽

Kidney Injury ◽

Perioperative Risk ◽

Perioperative Risk Factors

Aim. This study was conducted to determine the incidence of delirium after cardiac surgery and its effect on the length of the patient’s stay in the ICU and to identify the perioperative risk factors. Methods. This research was a retrospective assessment of 1941 medical records and the course of the perioperative period in patients subjected to elective cardiac surgery. Results. Delirium developed in 193 cases (9.94%); whereas, hyperactive, hypoactive and mixed delirium was observed in 13%, 43% and 44% of the patients, respectively. Most often (26% of the cases), delirium occurred after complex combined surgeries. Independent risk factors for the development of delirium were older age (OR 1.041, 95% CI [1.002–1.081], p = 0.038), EuroSCORE II score (OR 1.286, 95% CI [1.093–1.731], p = 0.025), acute kidney injury (OR 1.306, 95% CI [1.107–1.942], p = 0.0018) and renal replacement therapy (OR 1.399 95% CI [1.361–2.792], p = 0.001). Cardiopulmonary bypass duration and time of clamping of the aorta, postoperative serum creatinine level, need for blood transfusions and duration of mechanical ventilation and duration of ICU stay were identified as predictors and were also significantly higher in the delirium group. Delirium was closely associated with critical illness polyneuropathy (OR 9.201, 95% CI [2.13–38.826], p < 0.001) and neurogenic dysphagia (OR 7.48, 95% CI [1.12–56.07], p = 0.022). Conclusion. The key factors for delirium development in the postoperative period include advanced age, high EuroSCORE II scale and acute kidney injury requiring continuous renal replacement therapy. Delirium significantly increases the duration of mechanical ventilation and the duration of ICU stay.Received 30 January 2020. Revised 18 March 2020. Accepted 24 March 2020.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.Author contributions Conception and design: V.V. Pasyuga, I.N. Leiderman Data collection: D.A. Demin, E.V. Demina, I.L. Nudel, V.V. Pasyuga Data analysis: V.V. Pasyuga, I.N. Leiderman, D.A. Demin, D.G. Tarasov Drafting the article: V.V. Pasyuga, D.A. Demin Critical revision of the article: I.N. Leiderman, A.V. Kadykova Final approval of the version to be published: V.V. Pasyuga, D.A. Demin, I.L. Nudel, E.V. Demina, A.V. Kadykova, D.G. Tarasov, I.N. Leiderman

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