scholarly journals Hallucinations after Cardiac Surgery: A Prospective Observational Study

Medicina ◽  
2020 ◽  
Vol 56 (3) ◽  
pp. 104
Author(s):  
Thomas H. Ottens ◽  
Iris E.C. Sommer ◽  
Marieke J. Begemann ◽  
Maya Schutte ◽  
Maarten Jan Cramer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Cardiac Surgery ◽  
Observational Study ◽  
Postoperative Delirium ◽  
Prospective Observational Study ◽  
Common Type ◽  
Control Group ◽  
Visual Hallucinations ◽  
Psychotic Experiences

Background and Objective: Hallucinations after cardiac surgery can be a burden, but their prevalence and phenomenology have not been studied well. Risk factors for postoperative hallucinations, as well as their relation to delirium are unclear. We aimed to study the prevalence and phenomenology of hallucinations after cardiac surgery, and to study the association between hallucinations and delirium in this population. Materials and Methods: We used the Questionnaire for Psychotic Experiences to detect hallucinations in cardiac surgery patients and a control group of cardiology outpatients. We assessed postoperative delirium with validated instruments. Risk factors for postoperative hallucinations and the association between hallucinations and delirium were analysed using logistic regression. Results: We included 201 cardiac surgery patients and 99 cardiology outpatient controls. Forty-four cardiac surgery patients (21.9%) experienced postoperative hallucinations in the first four postoperative days. This was significantly higher compared to cardiology outpatient controls (n = 4, 4.1%, p < 0.001). Visual hallucinations were the most common type of hallucinations in cardiac surgery patients, and less common in outpatient controls. Cardiac surgery patients who experienced hallucinations were more likely to also have delirium (10/44, 22.7%) compared to patients without postoperative hallucinations (16/157, 10.2% p = 0.03). However, the majority of patients with postoperative hallucinations (34/44, 77.3%) did not develop delirium. Conclusion: After cardiac surgery, hallucinations occurred more frequently than in outpatient controls. Hallucinations after cardiac surgery were most often visual in character. Although postoperative hallucinations were associated with delirium, most patients with hallucinations did not develop delirium.

Prospective Incidence Study of Bloodstream Infection in Infants and Children With Central Venous Catheters After Cardiac Surgery in Italy

2009 ◽  
Vol 30 (7) ◽  
pp. 698-701 ◽  
Author(s):  
Stefania Bezzio ◽  
C. Scolfaro ◽  
R. Broglia ◽  
R. Calabrese ◽  
F. Mignone ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Observational Study ◽  
Bloodstream Infection ◽  
Medical Staff ◽  
Prospective Observational Study ◽  
Central Venous Catheters ◽  
Central Venous ◽  
In Infants And Children ◽  
Catheter Related Bloodstream Infection

This prospective observational study was designed to assess the incidence of, risk factors for, and outcome of catheter-related bloodstream infection in children undergoing cardiac surgery. A staff specifically trained to handle the central venous catheters with proper aseptic techniques and an appropriate patient to medical staff ratio remain the most effective measures to prevent this infection.

scholarly journals Intraoperative burst suppression is associated with postoperative delirium following cardiac surgery: a prospective, observational study

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Martin Soehle ◽  
Alexander Dittmann ◽  
Richard K Ellerkmann ◽  
Georg Baumgarten ◽  
Christian Putensen ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Observational Study ◽  
Postoperative Delirium ◽  
Prospective Observational Study ◽  
Burst Suppression

scholarly journals Risk factors for postoperative delirium and subsyndromal delirium in older surgical patients in the surgical ward: a prospective observational study

2020 ◽  
Author(s):  
Maya Kanno ◽  
Mana Doi ◽  
Kazumi Kubota ◽  
Yuka Kanoya
Keyword(s):  
Risk Factors ◽  
Observational Study ◽  
Older Patients ◽  
Postoperative Delirium ◽  
Prospective Observational Study ◽  
Physical Restraint ◽  
Assessment Method ◽  
Subsyndromal Delirium ◽  
Laboratory Test Results ◽  
Surgical Ward

Abstract Background: Postoperative delirium (POD) among older patients is a common, serious disease and is associated with a high incidence of negative outcomes. For early detection of POD and subsyndromal delirium (SSD), this study was conducted to identify risk factors of POD and SSD in older patients who were scheduled for surgery in a surgical ward.Methods: This was a prospective observational study. Study participants were older than 65 years, underwent urology surgery, and were hospitalized in the surgical ward between April and September 2019. Both POD and SSD were assessed by using the Confusion Assessment Method (CAM) on the preoperative day, the day of surgery, and postoperative days 1–3 by the surgical ward nurses. SSD was defined as the presence of one or more CAM criteria and the absence of a diagnosis of delirium based on the CAM algorithm. Personal characteristics, clinical data, cognitive function, physical functions, laboratory test results, medication use, type of surgery and anesthesia, and use of physical restraint were collected from medical records. Logistic regression analyses were conducted to identify the risk factors for POD and SSD.Results: A total of 101 participants (mean age 74.9 years) were enrolled; 19 (18.8%) developed POD and SSD. The use of bed sensors (odds ratio 10.2, p=.001) were identified as risk factors for POD and SSD.Conclusions: Our study shows that the use of bed sensors might be related to the development of POD and SSD among older patients in surgical wards.

scholarly journals Risk factors for postoperative delirium and subsyndromal delirium in older surgical patients in the general ward: a prospective observational study

2020 ◽  
Author(s):  
Maya Kanno ◽  
Mana Doi ◽  
Kazumi Kubota ◽  
Yuka Kanoya
Keyword(s):  
Risk Factors ◽  
Observational Study ◽  
Odds Ratio ◽  
Older Patients ◽  
Postoperative Delirium ◽  
Prospective Observational Study ◽  
General Ward ◽  
Subsyndromal Delirium ◽  
Laboratory Test Results ◽  
General Wards

Abstract Background Postoperative delirium (POD) among older patients is a common, serious disease and is associated with a high incidence of negative outcomes. For early detection of POD and subsyndromal delirium (SSD), this study was conducted to identify risk factors of POD and SSD in older patients in a general ward who were scheduled for surgery. Methods This was a prospective observational study. Study participants were older than 65 years, underwent urology surgery, and were hospitalized in the general ward between April and September 2019. Both POD and SSD were assessed by using the Confusion Assessment Method on the preoperative day, the day of surgery, and postoperative days 1–3. Personal characteristics, clinical data, cognitive function, physical functions, laboratory test results, medication use, type of surgery and anesthesia, and use of restraints were collected from medical records. Univariate and multivariate analyses were conducted to identify the risk factors for POD and SSD. Results A total of 101 participants (mean age 74.9 years) were enrolled; 19 (18.8%) developed POD and SSD. The use of bed sensors (odds ratio 10.2, p = .001) and preoperative level of C-reactive protein (CRP; odds ratio 1.5, p = .054) were identified as risk factors for POD and SSD. Conclusions POD and SSD among older patients in general wards were related to bed sensor use and the preoperative CRP level. Therefore, this study suggests that in order prevent POD and SSD for older patients in general wards, it is necessary to avoid bed sensor use as restraints and to assess the preoperative CRP level.

scholarly journals Risk factors for postoperative delirium and subsyndromal delirium in older patients in the surgical ward: A prospective observational study

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255607
Author(s):  
Maya Kanno ◽  
Mana Doi ◽  
Kazumi Kubota ◽  
Yuka Kanoya
Keyword(s):  
Risk Factors ◽  
Observational Study ◽  
Older Patients ◽  
Postoperative Delirium ◽  
Prospective Observational Study ◽  
Physical Restraint ◽  
Assessment Method ◽  
Subsyndromal Delirium ◽  
Laboratory Test Results ◽  
Surgical Ward

Postoperative delirium (POD) and subsyndromal delirium (SSD) among older patients is a common, serious condition associated with a high incidence of negative outcomes. However, there are few accurate methods for the early detection of POD and SSD in surgical wards. This study aimed to identify risk factors of POD and SSD in older patients who were scheduled for surgery in a surgical ward. This was a prospective observational study. Study participants were older than 65 years, underwent urology surgery, and were hospitalized in the surgical ward between April and September 2019. Delirium symptoms were assessed using the Confusion Assessment Method (CAM) on the preoperative day, the day of surgery, and postoperative days 1–3 by the surgical ward nurses. SSD was defined as the presence of one or more CAM criteria and the absence of a diagnosis of delirium based on the CAM algorithm. Personal characteristics, clinical data, cognitive function, physical functions, laboratory test results, medication use, type of surgery and anesthesia, and use of physical restraint and bed sensor were collected from medical records. Multiple logistic regression analyses were conducted to identify the risk factors for both POD and SSD. A total of 101 participants (mean age 74.9 years) were enrolled; 19 (18.8%) developed POD (n = 4) and SSD (n = 15). The use of bed sensors (odds ratio 10.2, p = .001) was identified as a risk factor for both POD and SSD. Our findings suggest that the use of bed sensors might be related to the development of both POD and SSD among older patients in surgical wards.

Analysis of risk factors for omental herniation associated with removal of peritoneal catheters

1997 ◽  
Vol 6 (6) ◽  
pp. 430-436 ◽  
Author(s):  
B Copnell ◽  
JD Best ◽  
B Capewell
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Cardiac Surgery ◽  
Peritoneal Dialysis ◽  
Preventive Measure ◽  
Control Group ◽  
Study Group ◽  
Intraperitoneal Bleeding ◽  
Omental Herniation

BACKGROUND: Peritoneal catheters may be used routinely in children undergoing cardiac surgery. Removal of the catheter is often complicated by omental herniation, which can cause intraperitoneal bleeding, peritonitis, and bowel obstruction. Instillation of saline into the catheter before removal is used in some institutions as a preventive measure, but the practice has never been investigated. OBJECTIVE: To determine the effectiveness of instilling saline into peritoneal catheters before their removal in reducing the occurrence of omental herniation and to determine risk factors for omental herniation. METHODS: A total of 404 patients with peritoneal catheters in place were randomized to either the control or the study group. The study group (n = 204) had saline (1 mL/kg; maximum, 10 mL) instilled into the catheter before the catheter was removed; the control group (n = 200) did not. Extrusion or no extrusion of omentum was recorded. Other data collected included the child's weight, the length of time the catheter was in place, whether peritoneal dialysis was performed, and whether the child was pharmacologically paralyzed when the catheter was removed. RESULTS: Extrusion of omentum occurred in 39% of the study group and in 33% of the controls. Results of logistic regression analysis suggested that omental herniation was more common in smaller children, children whose catheters remained in place longer, and children who were not pharmacologically paralyzed when the catheter was removed. CONCLUSIONS: Instillation of saline does not appear to reduce the occurrence of omental herniation. Further research into strategies to reduce this complication is recommended.

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