Christian Cereghetti1, Martin Siegemund2, Sabine Schaedelin3, Jens Fassl1, Manfred D Seeberger1, Friedrich S Eckstein4, Luzius A Steiner2, Nicolai Goettel5. 1. Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, University of Basel, Basel, Switzerland. 2. Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, University of Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland. 3. Department of Clinical Research, University of Basel, Basel, Switzerland. 4. Department of Cardiac Surgery, University Hospital Basel, University of Basel, Basel, Switzerland. 5. Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, University of Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland. Electronic address: nicolai.goettel@usb.ch.
Abstract
OBJECTIVE: Postoperative delirium (POD) is a common complication after cardiac surgery and is associated with increased patient morbidity and mortality. The objective of this study was to identify risk factors for long duration and overall burden of POD after cardiac surgery. DESIGN: One-year, single-center, retrospective, observational cohort study. SETTING: University hospital. PARTICIPANTS: Adult patients undergoing cardiac surgery with cardiopulmonary bypass in 2013. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Patients were screened for POD using the Intensive Care Delirium Screening Checklist. The primary outcome measure was the incidence of POD. Secondary outcome measures were the duration of POD and the area under the curve determined using the Intensive Care Delirium Screening Checklist score over time. Independent predictors of POD were estimated in multivariable logistic regression models. Hospital length of stay, medications, and outcome data also were analyzed. Among the 656 patients included in the cohort, 618 were analyzed. The overall incidence of POD was 39%. Older patient age (odds ratio [95% confidence interval]) 1.06 [1.04-1.09] for an increase of 1 year, p < 0.001); low preoperative serum albumin (1.08 [1.03-1.13] for a decrease of 1 g/L, p < 0.001); a history of atrial fibrillation (2.30 [1.30-4.09], p = 0.004); perioperative stroke (6.27 [1.54-43.64], p = 0.008); ascending aortic replacement surgery (2.99 [1.50-6.05], p = 0.002); longer duration of procedure (1.37 [1.16-1.63] for an increase of 1 hour, p < 0.001); and increased postoperative C-reactive protein concentration (2.16 [1.49-3.16] for a 2-fold increase, p < 0.001) were associated with higher odds of POD. Among patients affected by POD, older age, perioperative stroke, longer procedure time, and increased postoperative C-reactive protein were consistently predictive of longer duration of POD and greater area under the curve. CONCLUSIONS: Known risk factors for the development of POD after cardiac surgery also are predictive of prolonged duration and high overall burden of POD.
OBJECTIVE:Postoperative delirium (POD) is a common complication after cardiac surgery and is associated with increased patient morbidity and mortality. The objective of this study was to identify risk factors for long duration and overall burden of POD after cardiac surgery. DESIGN: One-year, single-center, retrospective, observational cohort study. SETTING: University hospital. PARTICIPANTS: Adult patients undergoing cardiac surgery with cardiopulmonary bypass in 2013. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS:Patients were screened for POD using the Intensive Care Delirium Screening Checklist. The primary outcome measure was the incidence of POD. Secondary outcome measures were the duration of POD and the area under the curve determined using the Intensive Care Delirium Screening Checklist score over time. Independent predictors of POD were estimated in multivariable logistic regression models. Hospital length of stay, medications, and outcome data also were analyzed. Among the 656 patients included in the cohort, 618 were analyzed. The overall incidence of POD was 39%. Older patient age (odds ratio [95% confidence interval]) 1.06 [1.04-1.09] for an increase of 1 year, p < 0.001); low preoperative serum albumin (1.08 [1.03-1.13] for a decrease of 1 g/L, p < 0.001); a history of atrial fibrillation (2.30 [1.30-4.09], p = 0.004); perioperative stroke (6.27 [1.54-43.64], p = 0.008); ascending aortic replacement surgery (2.99 [1.50-6.05], p = 0.002); longer duration of procedure (1.37 [1.16-1.63] for an increase of 1 hour, p < 0.001); and increased postoperative C-reactive protein concentration (2.16 [1.49-3.16] for a 2-fold increase, p < 0.001) were associated with higher odds of POD. Among patients affected by POD, older age, perioperative stroke, longer procedure time, and increased postoperative C-reactive protein were consistently predictive of longer duration of POD and greater area under the curve. CONCLUSIONS: Known risk factors for the development of POD after cardiac surgery also are predictive of prolonged duration and high overall burden of POD.
Authors: Sophia Wang; Ryan Greene; Yiqing Song; Carol Chan; Heidi Lindroth; Sikandar Khan; Gabriel Rios; Robert D Sanders; Babar Khan Journal: Int Psychogeriatr Date: 2022-01-17 Impact factor: 7.191
Authors: Jan Menzenbach; Stilla Frede; Janine Petras; Vera Guttenthaler; Andrea Kirfel; Claudia Neumann; Andreas Mayr; Maria Wittmann; Mark Coburn; Sven Klaschik; Tobias Hilbert Journal: Biomedicines Date: 2021-05-15
Authors: Alain Deschamps; Tarit Saha; Renée El-Gabalawy; Eric Jacobsohn; Charles Overbeek; Jennifer Palermo; Sophie Robichaud; Andrea Alicia Dumont; George Djaiani; Jo Carroll; Morvarid S Kavosh; Rob Tanzola; Eva M Schmitt; Sharon K Inouye; Jordan Oberhaus; Angela Mickle; Arbi Ben Abdallah; Michael S Avidan; Canadian Perioperative Anesthesia Clinical Trials Group Journal: F1000Res Date: 2019-07-23