Literature DB >> 18345523

[Confusion Assessment Method for the Intensive Care Unit (CAM-ICU): diagnosis of postoperative delirium in cardiac surgery].

M Klugkist1, B Sedemund-Adib, C Schmidtke, P Schmucker, H H Sievers, M Hüppe.   

Abstract

OBJECTIVE: Since 2001 the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), a method for the diagnosis of delirium, has been available for the Anglo American area which can also be applied to mechanically ventilated patients. This study was conducted to answer the following questions: 1. Can a German version of the CAM-ICU be applied to patients after cardiac surgery? 2. What is the prevalence rate of postoperative delirium after cardiac surgery diagnosed by the CAM-ICU? 3. Do patients with and without the diagnosis delirium differ in the clinical variables usually associated with this disorder in cardiac surgery?
METHODS: A total of 194 patients undergoing cardiac surgery served as the analysis sample (85.5% of the total group). The CAM-ICU was carried out every day for 5 days after the operation. Sociodemographic and clinical variables were collected to examine the validity of CAM-ICU. Postoperative complaints were assessed by the Anaesthesiological Questionnaire for Patients (ANP).
RESULTS: Postoperatively, the CAM-ICU could be applied to almost all patients without any problems. The prevalence rate of delirium was 28.4% and 85.5% of the delirium diagnosed was a hypoactive subtype when diagnosed for the first time. Patients with delirium diagnosed by CAM-ICU were older (p<0.001), had a lower educational level (p<0.05), longer anaesthesia time and operation time (p<0.05), a longer postoperative ICU stay (p<0.001), were mechanically ventilated for a longer time postoperatively (p<0.001), more often reintubated (p<0.01) and had higher leucocytes postoperatively (p<0.10). More patients with delirium had the lowest postoperatively measured oxygen saturation below 95% (p<0.01).
CONCLUSION: The CAM-ICU is an economic method for the assessment of delirium which can easily be learned. It can be applied to patients after cardiac surgery without any problems.

Entities:  

Mesh:

Year:  2008        PMID: 18345523     DOI: 10.1007/s00101-008-1356-4

Source DB:  PubMed          Journal:  Anaesthesist        ISSN: 0003-2417            Impact factor:   1.041


  30 in total

1.  The concept of delirium.

Authors:  J Lindesay
Journal:  Dement Geriatr Cogn Disord       Date:  1999 Sep-Oct       Impact factor: 2.959

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5.  Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU).

Authors:  E W Ely; S K Inouye; G R Bernard; S Gordon; J Francis; L May; B Truman; T Speroff; S Gautam; R Margolin; R P Hart; R Dittus
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7.  Fatigue in chronically critically ill patients following intensive care - reliability and validity of the multidimensional fatigue inventory (MFI-20).

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9.  Correlation of Preoperative Renal Insufficiency With Mortality and Morbidity After Aortic Valve Replacement: A Propensity Score Matching Analysis.

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10.  Acetylcholinesterase and butyrylcholinesterase in cardiosurgical patients with postoperative delirium.

Authors:  Mira John; E Wesley Ely; Dorothee Halfkann; Julika Schoen; Beate Sedemund-Adib; Stefan Klotz; Finn Radtke; Sebastian Stehr; Michael Hueppe
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