Congestive heart failure as a determinant of postoperative delirium

Parente, D.; Luís, C.; Veiga, D.; Silva, Hugo; Abelha, Fernando

doi:10.1016/j.repc.2012.12.020

Cited by 29 publications

(11 citation statements)

References 32 publications

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“…Systemic inflammatory response and increased need for blood transfusions have been determined to be independent risk factors and could be strongly tied to length of surgery [16,18,33]. Furthermore, the length of time spent under mechanical ventilation is correlated with both duration of surgery and of anesthesia, due to longer procedures requiring prolonged mechanical ventilation [18,34]. As previously discussed, complex surgeries have many risk factors for POD, and prolonged intubation is another component to consider.…”

Section: Discussionmentioning

confidence: 99%

“…Another very strong risk factor is a decrease in blood proteins, with both studies investigating this factor finding a correlation coefficient below 0.005 [23,31]. A decreased RBC count is a strong risk factor for delirium with two articles demonstrating a highly significant correlation between a decrease in RBC and delirium [31,34]. Elevated creatinine levels are a strong risk factor for delirium with nine of twelve studies finding it significant [16,23,27,28,32,33,35] (Table 4).…”

Section: Medicationsmentioning

confidence: 99%

“…Another potential risk factor is the time spent under mechanical ventilation. This risk factor is correlated with both duration of surgery and of anesthesia, as longer anesthetized procedures require longer mechanical ventilation [18,34]. When patients are intubated, they are sedated by drugs which can alter brain function and cause increased risk for delirium [27].…”

Section: Length Of Treatmentsmentioning

confidence: 99%

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A Survey of Electronic Health Record (EHR) Variables Associated with Postoperative Delirium: A Systematic Review

Ruppert

Hashemighouchani

Bihorac

et al. 2020

Preprint

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Introduction: Delirium is a common post-operative complication in critically ill patients, displaying transient changes in consciousness, inattention, awareness, and organized thought. Not a lot is known about the specific causes of this condition, as it is a complex physiologic state that is currently being unraveled to determine any correlation with imbalances in homeostasis. Objective: The aim of this systematic review is to report on and summarize risk factors associated with the development of postoperative delirium in critically ill adult patients. Methods: This systematic review assessed studies reporting on risk factors for postoperative delirium in critically ill patients. PubMed, PsycINFO, and CINAHL databases were searched for studies. Observational or interventional studies reviewing predictors for postoperative delirium in delirious versus non-delirious patients were included. Results: Fifty-one potential risk factors were identified and divided into eight subgroups. The significance of a specific risk factor for postoperative delirium was found to depend on the patient population in question, but consistently cited significant risk factors across cohorts included high mortality risk, abnormal laboratory values, and use of vasopressors, analgesics, thiopentones, propofol, and benzodiazepines. There was not enough evidence found to definitively state the significance of type of surgery being performed or cognitive impairment on development of this condition. Conclusion: Several risk factors were found to be significantly associated with the development of postoperative delirium, including high risk of mortality, specific medication use, and abnormal laboratory values. Further research needs to be performed to fully define the importance of these individual risk factors across broad critical care population.

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Section: Discussionmentioning

confidence: 99%

Section: Medicationsmentioning

confidence: 99%

Section: Length Of Treatmentsmentioning

confidence: 99%

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A Survey of Electronic Health Record (EHR) Variables Associated with Postoperative Delirium: A Systematic Review

Ruppert

Hashemighouchani

Bihorac

et al. 2020

Preprint

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“…37,38,39,40 Delirium, a common sequela of decompensated HF, is associated with prolonged hospital stays and increased mortality. 41 Disease management programmes and aerobic exercise seem to be as effective as drug therapy, 55 and repeated visits from nurses and routine contact calls from healthcare staff to give education and care support were found to reduce hospital readmissions and increase quality of life. 56…”

Section: Several Risk Factors For Stroke In Patients With Hf Have Beementioning

confidence: 99%

Heart–brain Interactions in Heart Failure

Scherbakov

Doehner

2018

Cardiac Failure Review

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Heart failure (HF) is a complex disease with a growing incidence worldwide. HF is accompanied by a wide range of conditions which affect disease progression, functional performance and contribute to growing healthcare costs. The interactions between a failing myocardium and altered cerebral functions contribute to the symptoms experienced by patients with HF, affecting many comorbidities and causing a poor prognosis. This article provides a condensed version of the 2018 position paper from the Study Group on Heart and Brain Interaction of the Heart Failure Association. It addresses the reciprocal impact on HF of several pathological brain conditions, including acute and chronic low perfusion of the brain, and impairment of higher cortical and brain stem functions. Treatment-related interactions - medical, interventional and device-related - are also discussed.

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“…10 Another study found that heart disease was a risk factor. 11 Risk factors of delirium in outpatients have been studied in just a few studies. These studies reported that infections, stressful events, surgery, medical illnesses, heart failure, metabolic-endocrine disturbances, and the use of medication like benzodiapines and haldoperidol, as well as polypharmacy were associated with an increased risk of prevalent delirium.…”

mentioning

confidence: 99%

Prevalence and risk factors of delirium in psychogeriatric outpatients

Quispel-Aggenbach

Ruiter

Bergen

et al. 2020

Int J Geriat Psychiatry

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Background: Delirium is a serious neuropsychiatric syndrome, which requires timely treatment. However, it is easily missed, especially in older patients with premorbid cognitive disorders. Objectives: The aim of this study is to investigate the prevalence and risk factors of delirium in older outpatients with and without dementia. Method: We assessed 444 patients referred to the memory clinic of a psychiatric hospital between March 2013 and March 2014. Demographic information, medical history, impairments in daily living activities and referral information were registered. Patients underwent a psychiatric examination using the Delirium Rating Scale-Revised-98 and cognitive tests, a physical examination and laboratory tests. We recorded medication use and changes before and after the onset of symptoms. Results: Among the 444 outpatients, 85 had probable delirium (prevalence of 19%), and 10 had subsyndromal delirium (2%). The most common triggers were infection (42%), drug-intoxication or withdrawal (22%), and metabolic/endocrine disturbance (12%). Age (OR 1.07, 95% CI 1.02-1.11) and prior delirium (OR 3.34, 95% CI 1.28-8.69) were independent non-modifiable factors associated with an increased risk of delirium. The only independent modifiable risk factor was infection (OR 17.31, 95% CI 8.44-35.49). Conclusions: A delirium was detected in one of five patients referred for dementia screening. Most patients could be treated at home. Age and prior delirium were predictive of an increased risk of delirium.

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Congestive heart failure as a determinant of postoperative delirium

Abstract: Patients who developed POD had longer hospital and PACU stays and higher in-hospital mortality. Congestive heart disease was considered an independent risk factor for POD.

Cited by 29 publications

References 32 publications

A Survey of Electronic Health Record (EHR) Variables Associated with Postoperative Delirium: A Systematic Review

A Survey of Electronic Health Record (EHR) Variables Associated with Postoperative Delirium: A Systematic Review

Heart–brain Interactions in Heart Failure

Prevalence and risk factors of delirium in psychogeriatric outpatients

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