Evaluation of the Prevalence and Risk Factors of Delirium in Cardiac Surgery ICU

Shadvar, Kamran; Baastani, Farzaneh; Mahmoodpoor, Ata; Bilehjani, Eissa

doi:10.5681/jcvtr.2013.034

Cited by 15 publications

(6 citation statements)

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“…A total of 19785 patients were included and the male proportion of each study varied from 36.9 to 84.3%. Concerning procedure types, it includes acute CABG ( 22 , 38 , 42 , 48 , 53 ), valve surgery ( 10 , 21 , 26 , 31 – 33 , 46 , 49 , 51 ), AAD surgery ( 44 , 52 , 54 , 57 ), and mixed cardiac surgery ( 9 , 12 , 19 , 20 , 23 – 25 , 27 – 29 , 35 , 36 , 47 , 55 , 56 ).…”

Section: Resultsmentioning

confidence: 99%

“…As for the assessment tool for POD, a total of 33 studies were reported using a single measurement. Among them, 15 studies used CAM-ICU ( 10 , 21 , 22 , 25 , 30 , 36 , 39 , 41 , 44 – 46 , 49 , 50 , 52 , 55 ), six studies used DMS-4 ( 26 , 31 , 38 , 40 , 42 , 53 ), 2 studies used DMS-5 ( 12 , 57 ), five studies used ICDSC ( 9 , 24 , 37 , 47 , 54 ), two studies used CAM ( 34 , 56 ), two studies used DOS ( 20 , 33 ), and one study used CHART-DEL ( 29 ). Two or more tools were used to diagnose delirium in other studies ( 19 , 23 , 27 – 29 , 35 , 43 , 48 , 51 ).…”

Section: Resultsmentioning

confidence: 99%

“…Twenty studies ( 9 , 12 , 22 , 24 , 25 , 28 – 30 , 34 – 36 , 42 , 47 , 48 , 53 ) reported the MV time as an outcome measure, which included 13503 individuals. Using a random-effects model, the pooled SMD was 0.83 (SMD = 0.83, 95% CI 0.57–1.09, P < 0.001) with significant heterogeneity ( I 2 = 95%), which showed that patients with POD had significantly longer MV time compared to those without POD ( Figure 2C ).…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-two studies ( 9 , 12 , 19 , 23 – 25 , 27 , 29 , 30 , 34 , 47 , 52 , 53 , 56 ) reported the ICU time as an outcome measure, which included 9231 individuals. The results with a random-effects model showed that the ICU time was significantly longer for patients with POD than for those without POD patients (SMD = 0.91, 95% CI 0.60–1.22, P < 0.001) with significant heterogeneity ( I 2 = 96%; Figure 2D ).…”

Section: Resultsmentioning

confidence: 99%

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Outcomes of postoperative delirium in patients undergoing cardiac surgery: A systematic review and meta-analysis

Lin

Zhang

et al. 2022

Front. Cardiovasc. Med.

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BackgroundPostoperative delirium (POD) is an acute brain dysfunction that is frequently observed in patients undergoing cardiac surgery. Increasing evidence indicates POD is related to higher mortality among cardiac surgical patients, but the results remain controversial. Moreover, a quantitative evaluation of the influence of POD on hospital days, intensive care unit (ICU) time, and mechanical ventilation (MV) time has not been performed.ObjectiveThis study aimed to evaluate the correlation between POD and outcomes in patients undergoing cardiac surgery by a systematic review and meta-analysis.Materials and methodsA total of 7 electronic databases (Cochrane Library, PubMed, EMBASE, CINAHL Complete, MEDLINE, Wan-fang database, and China National Knowledge Infrastructure) were searched from January 1980 to July 20, 2021, with language restrictions to English and Chinese, to estimate the impact of the POD on outcome in patients who underwent cardiac surgery. The meta-analysis was registered with PROSPERO (Registration: CRD42021228767).ResultsForty-two eligible studies with 19785 patients were identified. 3368 (17.0%) patients were in the delirium group and 16417 (83%) were in the non-delirium group. The meta-analysis showed that compared to patients without POD, patients with POD had 2.77-fold higher mortality (OR = 2.77, 95% CI 1.86–4.11, P < 0.001), 5.70-fold higher MV (>24h) rate (OR = 5.70, 95% CI 2.93–11.09, P < 0.001); and longer MV time (SMD = 0.83, 95% CI 0.57–1.09, P < 0.001), ICU time (SMD = 0.91, 95% CI 0.60–1.22, P < 0.001), hospital days (SMD = 0.62, 95% CI 0.48–0.76, P < 0.001).ConclusionThe synthesized evidence suggests that POD is causally related to the increased risk of mortality, prolonged length of ICU and hospital stay, and a longer duration of MV time. Future research should focus on the interventions for POD, to reduce the incidence.Systematic review registration[www.crd.york.ac.uk/PROSPERO], identifier [CRD42021228767].

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Outcomes of postoperative delirium in patients undergoing cardiac surgery: A systematic review and meta-analysis

Lin

Zhang

et al. 2022

Front. Cardiovasc. Med.

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“…It requires immediate surgery [ 1 ], and postoperative delirium (POD) is a prominent postoperative complication [ 2 ]. POD is characterized by acute cognitive impairment, with fluctuating consciousness and attention following heart surgery [ 3 ]. Moreover, POD is intricately linked to reduced mobility, enhanced intensive care unit (ICU) stay, high costs, and undesirable patient prognosis [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Thyroid hormone, cortisol, interleukin-2, and procalcitonin regulate postoperative delirium in acute type A aortic dissection patients

Zheng

Chen

Luo

2022

BMC Cardiovasc Disord

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Background We assessed the relationships between levels of preoperative thyroid hormone (TH), cortisol, interleukin-2 (IL-2), and procalcitonin (PCT) and postoperative delirium (POD) in acute type A aortic dissection (ATAAD) patients receiving modified triple-branched stent-graft (MTBSG) implant surgeries. Methods ATAAD patients received MTBSG implant surgeries in our hospital between February 2019 and December 2020 were recruited. We separated them into a POD and non-POD cohort and employed univariable and multivariable regression analysis to establish independent correlations between preoperative THs, cortisol, IL-2, and PCT and POD. In addition, we conducted stratification analyses to examine the link between pre-surgical THs and POD in normal TSH and lower TSH subgroups. Results POD occurred in 78 of 224 patients (34.8%). POD patients exhibited markedly reduced preoperative free triiodothyronine (FT3) (P = 0.008) and free thyroxine (FT4) (P = 0.023) levels, while remarkably enhanced preoperative cortisol (P < 0.001), IL-2 (P < 0.001), and PCT (P < 0.001) levels. Based on multivariate regression analysis, reduced preoperative FT3 (P = 0.032), as well as augmented preoperative IL-2 (P = 0.001), cortisol (P < 0.001), and PCT (P = 0.016) were strong stand-alone risk factors for POD. Moreover, subgroup analysis found the association between FT3 (P = 0.029), FT4 (P = 0.042) and POD was both significant in patients with normal TSH levels. Conclusions Reduced preoperative FT3 and elevated preoperative cortisol, IL-2, and PCT were strong indicators of POD in ATAAD patients. Hence, we recommend that the thyroid function, cortisol, PCT, and IL-2 should be evaluated prior to surgery in ATAAD patients.

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Factors Associated With Hospital Length of Stay Following Fibular Free-Tissue Reconstruction of Head and Neck Defects

White

Zhang

Strickland

et al. 2015

JAMA Otolaryngol Head Neck Surg

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Evaluation of the Prevalence and Risk Factors of Delirium in Cardiac Surgery ICU

Cited by 15 publications

References 15 publications

Outcomes of postoperative delirium in patients undergoing cardiac surgery: A systematic review and meta-analysis

Outcomes of postoperative delirium in patients undergoing cardiac surgery: A systematic review and meta-analysis

Thyroid hormone, cortisol, interleukin-2, and procalcitonin regulate postoperative delirium in acute type A aortic dissection patients

Factors Associated With Hospital Length of Stay Following Fibular Free-Tissue Reconstruction of Head and Neck Defects

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