Hsiao-Wei Cheng1, Chieh-Yu Liu2, Yih-Sharng Chen3, Chun-Che Shih4,5,6,7, Wei-Yi Chen8, Ai-Fu Chiou9. 1. Department of Nursing, National Taiwan University Hospital, No.7, Chung Shan South Road, Zhongzheng Dist., Taipei 100, Taiwan. 2. Biostatistical Consultant Lab, Department of Health Care Management, National Taipei University of Nursing and Health Sciences, No.365, Ming-te Road, Peitou District, Taipei 112, Taiwan. 3. Department of Surgery, Cardiovascular Surgery & Ped Cardiovascular Surgery, National Taiwan University Hospital, and College of Medicine, National Taiwan University, No.7, Chung Shan South Road, Zhongzheng Dist., Taipei 100, Taiwan. 4. Taipei Heart Institute, Taipei Medical University, No. 250 Wu-Hsing St. Taipei 110, Taiwan. 5. Division of Cardiovascular Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, No. 111, Sec.3, Xinglong Rd., Wenshan Dist., Taipei 116, Taiwan. 6. Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, No. 250 Wu-Hsing St. Taipei 110, Taiwan. 7. Institute of Clinical Medicine, Department of Surgery, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Li-Nong St., Taipei 112, Taiwan. 8. Department of Nursing, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei 112, Taiwan. 9. College of Nursing, Institute of Clinical Nursing, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Li-Nong St., Taipei 112, Taiwan.
Abstract
BACKGROUND: Postoperative delirium (POD) is a common complication that may occur from 24 to 72 h after cardiac surgery. Frailty is a chronic syndrome that leads to a decline in physiological reserve and to disability. The associations between frailty and POD are unclear. AIMS: To investigate associations between POD and frailty in patients undergoing cardiac surgery and to analyse predictors of POD. METHODS AND RESULTS: Convenience sampling was used to recruit 152 patients who underwent cardiac surgery in two medical centres in northern Taiwan. Preoperative frailty in these patients was evaluated using Fried's frailty phenotype. Delirium in patients was assessed from postoperative day 1 to day 5 using the confusion assessment method for intensive care units. A total of 152 patients who underwent cardiac surgery included 68 (44.74%) prefrail patients and 21 (13.81%) patients with frailty after the surgery. Ten patients (6.58%) developed delirium after cardiac surgery. The occurrence of delirium peaked at postoperative day 2, and the average duration of delirium was 3 days. A case-control comparison revealed a significant correlation between preoperative frailty and POD. Significant predictors of POD in patients undergoing cardiac surgery included the European System for Cardiac Operative Risk Evaluation II, preoperative arrhythmia, and preoperative anxiety and depression. CONCLUSION: Preoperative frailty was correlated with POD. Preoperative arrhythmia, anxiety, and depression are predictors of POD. Nurses should perform preoperative assessments of surgical risk and physiological and psychological conditions of patients undergoing cardiac surgery and monitor the occurrence of POD. Published on behalf of the European Society of Cardiology. All rights reserved.
BACKGROUND: Postoperative delirium (POD) is a common complication that may occur from 24 to 72 h after cardiac surgery. Frailty is a chronic syndrome that leads to a decline in physiological reserve and to disability. The associations between frailty and POD are unclear. AIMS: To investigate associations between POD and frailty in patients undergoing cardiac surgery and to analyse predictors of POD. METHODS AND RESULTS: Convenience sampling was used to recruit 152 patients who underwent cardiac surgery in two medical centres in northern Taiwan. Preoperative frailty in these patients was evaluated using Fried's frailty phenotype. Delirium in patients was assessed from postoperative day 1 to day 5 using the confusion assessment method for intensive care units. A total of 152 patients who underwent cardiac surgery included 68 (44.74%) prefrail patients and 21 (13.81%) patients with frailty after the surgery. Ten patients (6.58%) developed delirium after cardiac surgery. The occurrence of delirium peaked at postoperative day 2, and the average duration of delirium was 3 days. A case-control comparison revealed a significant correlation between preoperative frailty and POD. Significant predictors of POD in patients undergoing cardiac surgery included the European System for Cardiac Operative Risk Evaluation II, preoperative arrhythmia, and preoperative anxiety and depression. CONCLUSION: Preoperative frailty was correlated with POD. Preoperative arrhythmia, anxiety, and depression are predictors of POD. Nurses should perform preoperative assessments of surgical risk and physiological and psychological conditions of patients undergoing cardiac surgery and monitor the occurrence of POD. Published on behalf of the European Society of Cardiology. All rights reserved.