OBJECTIVES: Postoperative delirium is a common psychiatric disorder among patients who undergo cardiac surgery. Although several studies have investigated risk factors for delirium after cardiac surgery, the association between delirium and cerebral white-matter hyperintensities (WMH) on magnetic resonance (MR) imaging has not been previously studied. The aim of this study was to identify general risk factors for delirium, as well as to examine the specific relationship between WMH and delirium. DESIGN: Retrospective chart review. SETTING: University hospital. PARTICIPANTS: A total of 130 patients who underwent cardiac surgery. MEASUREMENTS: Variables recorded included patient demographics, comorbidities, mental health, laboratory data, surgical information, and cerebrovascular disease. The presence of WMH was assessed using MR images. Two groups of patients were compared (patients with and without delirium) using both univariate and multiple logistic analyses. RESULTS: Delirium occurred in 18 patients (13.8%) and patients with delirium were significantly older than patients who did not develop delirium. The prevalence of severe WMH (Fazekas score = 3) was significantly higher in patients with delirium. Three independent predictors of delirium were identified: abnormal creatinine (odds ratio [OR]: 4.5; 95% confidence interval [CI]: 1.4-13.9), severe WMH (OR: 3.9; 95% CI: 1.2-12.5), and duration of surgery (OR: 1.4; 95% CI: 1.0-1.8). CONCLUSIONS: The results of this study suggest that white-matter abnormality is one of the most important risk factors for development of delirium after cardiac surgery. These factors can be used for prediction and prevention of delirium following cardiac surgery.
OBJECTIVES:Postoperative delirium is a common psychiatric disorder among patients who undergo cardiac surgery. Although several studies have investigated risk factors for delirium after cardiac surgery, the association between delirium and cerebral white-matter hyperintensities (WMH) on magnetic resonance (MR) imaging has not been previously studied. The aim of this study was to identify general risk factors for delirium, as well as to examine the specific relationship between WMH and delirium. DESIGN: Retrospective chart review. SETTING: University hospital. PARTICIPANTS: A total of 130 patients who underwent cardiac surgery. MEASUREMENTS: Variables recorded included patient demographics, comorbidities, mental health, laboratory data, surgical information, and cerebrovascular disease. The presence of WMH was assessed using MR images. Two groups of patients were compared (patients with and without delirium) using both univariate and multiple logistic analyses. RESULTS:Delirium occurred in 18 patients (13.8%) and patients with delirium were significantly older than patients who did not develop delirium. The prevalence of severe WMH (Fazekas score = 3) was significantly higher in patients with delirium. Three independent predictors of delirium were identified: abnormal creatinine (odds ratio [OR]: 4.5; 95% confidence interval [CI]: 1.4-13.9), severe WMH (OR: 3.9; 95% CI: 1.2-12.5), and duration of surgery (OR: 1.4; 95% CI: 1.0-1.8). CONCLUSIONS: The results of this study suggest that white-matter abnormality is one of the most important risk factors for development of delirium after cardiac surgery. These factors can be used for prediction and prevention of delirium following cardiac surgery.
Authors: Michele Cavallari; Weiying Dai; Charles R G Guttmann; Dominik S Meier; Long H Ngo; Tammy T Hshieh; Amy E Callahan; Tamara G Fong; Eva Schmitt; Bradford C Dickerson; Daniel Z Press; Edward R Marcantonio; Richard N Jones; Sharon K Inouye; David C Alsop Journal: Brain Date: 2016-02-26 Impact factor: 13.501
Authors: Michele Cavallari; Tammy T Hshieh; Charles R G Guttmann; Long H Ngo; Dominik S Meier; Eva M Schmitt; Edward R Marcantonio; Richard N Jones; Cyrus M Kosar; Tamara G Fong; Daniel Press; Sharon K Inouye; David C Alsop Journal: Neurobiol Aging Date: 2015-02-28 Impact factor: 4.673
Authors: Tammy T Hshieh; Weiying Dai; Michele Cavallari; Charles Rg Guttmann; Dominik S Meier; Eva M Schmitt; Bradford C Dickerson; Daniel Z Press; Edward R Marcantonio; Richard N Jones; Yun Ray Gou; Thomas G Travison; Tamara G Fong; Long Ngo; Sharon K Inouye; David C Alsop Journal: J Cereb Blood Flow Metab Date: 2016-01-01 Impact factor: 6.200
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: Elizabeth Mahanna-Gabrielli; Katie J Schenning; Lars I Eriksson; Jeffrey N Browndyke; Clinton B Wright; Deborah J Culley; Lis Evered; David A Scott; Nae Yah Wang; Charles H Brown; Esther Oh; Patrick Purdon; Sharon Inouye; Miles Berger; Robert A Whittington; Catherine C Price; Stacie Deiner Journal: Br J Anaesth Date: 2019-08-19 Impact factor: 9.166
Authors: James C Root; Kane O Pryor; Robert Downey; Yesne Alici; Marcus L Davis; Andrei Holodny; Beatriz Korc-Grodzicki; Tim Ahles Journal: Psychooncology Date: 2013-03-04 Impact factor: 3.894
Authors: Mark A Oldham; Keith A Hawkins; I-Hsin Lin; Yanhong Deng; Qing Hao; Leslie M Scoutt; David D Yuh; Hochang B Lee Journal: Am J Geriatr Psychiatry Date: 2018-12-25 Impact factor: 4.105
Authors: David L McDonagh; Miles Berger; Joseph P Mathew; Carmelo Graffagnino; Carmelo A Milano; Mark F Newman Journal: Lancet Neurol Date: 2014-04-02 Impact factor: 44.182