BACKGROUND AND AIMS: To identify pre-operative risk factors for delirium in patients undergoing elective cardiac surgery, using clearly defined diagnostic criteria for delirium, and a thorough clinical assessment. METHODS: The incidence of post-operative delirium in 107 patients >or=60 years undergoing elective cardiac surgery was calculated. None of the patients included suffered from dementia. Pre-operative cognitive function in all patients was assessed using the Mini Mental State Examination (MMSE) and post-operative delirium was diagnosed using the Confusion Assessment Method (CAM). Post-operative clinical and cognitive assessments were carried out for all patients. RESULTS: Twenty-five patients (23.4%) developed delirium post-operatively. Clinical parameters, including age, gender, co-morbidities, medications, and peri-operative parameters, were similar in patients with and without post-operative delirium. Patients with pre-operative subjective memory complaints and lower MMSE scores, undergoing valve operation or valve + coronary artery bypass grafting (CABG), exhibited an increased risk of developing post-operative delirium. Additionally, delirious patients had a significant decline in post-operative MMSE score compared with the non-delirious ones. CONCLUSIONS: The main pre-operative risk factors for post-operative delirium after elective cardiac operations were subjective memory complaints, mild cognitive impairment, and type of cardiac surgery, such as valve procedures. This study suggests that cognitive evaluation should be included in pre-operative assessment.
BACKGROUND AND AIMS: To identify pre-operative risk factors for delirium in patients undergoing elective cardiac surgery, using clearly defined diagnostic criteria for delirium, and a thorough clinical assessment. METHODS: The incidence of post-operative delirium in 107 patients >or=60 years undergoing elective cardiac surgery was calculated. None of the patients included suffered from dementia. Pre-operative cognitive function in all patients was assessed using the Mini Mental State Examination (MMSE) and post-operative delirium was diagnosed using the Confusion Assessment Method (CAM). Post-operative clinical and cognitive assessments were carried out for all patients. RESULTS: Twenty-five patients (23.4%) developed delirium post-operatively. Clinical parameters, including age, gender, co-morbidities, medications, and peri-operative parameters, were similar in patients with and without post-operative delirium. Patients with pre-operative subjective memory complaints and lower MMSE scores, undergoing valve operation or valve + coronary artery bypass grafting (CABG), exhibited an increased risk of developing post-operative delirium. Additionally, delirious patients had a significant decline in post-operative MMSE score compared with the non-delirious ones. CONCLUSIONS: The main pre-operative risk factors for post-operative delirium after elective cardiac operations were subjective memory complaints, mild cognitive impairment, and type of cardiac surgery, such as valve procedures. This study suggests that cognitive evaluation should be included in pre-operative assessment.
Authors: Peter Stachon; Klaus Kaier; Andreas Zirlik; Jochen Reinöhl; Timo Heidt; Wolfgang Bothe; Philip Hehn; Manfred Zehender; Christoph Bode; Constantin von Zur Mühlen Journal: Clin Res Cardiol Date: 2018-04-13 Impact factor: 5.460
Authors: Charles H Brown; Roland Faigle; Lauren Klinker; Mona Bahouth; Laura Max; Andrew LaFlam; Karin J Neufeld; Kaushik Mandal; Rebecca F Gottesman; Charles W Hogue Journal: Clin Ther Date: 2015-11-29 Impact factor: 3.393
Authors: Annie M Racine; Tamara G Fong; Yun Gou; Thomas G Travison; Douglas Tommet; Kristen Erickson; Richard N Jones; Bradford C Dickerson; Eran Metzger; Edward R Marcantonio; Eva M Schmitt; Sharon K Inouye Journal: Alzheimers Dement Date: 2017-11-27 Impact factor: 21.566