Midterm outcomes after postoperative delirium on cognition and mood in patients after cardiac surgery

Nguyen, Quyen; Uminski, Kelsey; Hiebert, Brett; Tangri, Navdeep; Arora, Rakesh C.

doi:10.1016/j.jtcvs.2017.09.131

Cited by 30 publications

(22 citation statements)

References 33 publications

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“…Many of previous studies [28,37] agree with our findings that postoperative verbal memory decline was correlated with length of bypass time. In contrast to our study, Nguyen et al [31] observed no differences in cognitive functions between the delirious and non-delirious subjects after 6 to 9 months. This dissimilarity in the reported severity and type of cognitive dysfunction between different studies may be attributed to the difference in: methodology, study population characteristics, the selected definition of cognitive impairment, and the time of postoperative evaluation.…”

Section: Discussioncontrasting

confidence: 99%

“…As regards predictors affecting cognitive functions, this research found no significant differences in cognitive performance between male and female patients and also between smokers and non-smokers. These results were in the same line with many of previous studies [26,31,32]. In our work, we found no role for ICU-LOS on cognition as documented also by Harrington et al [33].…”

Section: Discussionsupporting

confidence: 94%

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Psychiatric disturbances in patients undergoing open-heart surgery

Younes

Amer

Fawzy

et al. 2019

Middle East Curr Psychiatry

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Background: Emotional and behavioral problems have been noted in a considerable number of patients after open-heart surgery. However, great discrepancy exists in the literature regarding the frequency and the course of psychiatric symptoms, cognitive performance, and quality of life among those patients. This prospective study was designed to assess the pre-and postoperative psychiatric profile, as well as the quality of life of patients undergoing open-heart surgery. Methods: One hundred patients who were prepared for cardiac surgery and met our selection criteria were recruited in this study. Each patient was subjected to the Hospital Anxiety and Depression Scale, the Mini-Mental State Examination with selective subtests of Wechsler Adult intelligence scale, and the Short Form 36 questionnaire to assess psychiatric symptoms, cognitive performance, and quality of life respectively. Assessment was done for each of the evaluated items before surgery as well as at 1 week and 6 months postoperatively. Results: The anxiety and depressive symptoms were significantly lower at 6 months postoperatively than preoperatively. The cognitive performance declined after 1 week, then improved significantly at the 6-month follow-up. The quality of life scale was significantly lower preoperatively than after surgery. Conclusions: Anxiety and depressive symptoms, which occurred in substantial percentage of patients undergoing open-heart surgery, were gradually improved with time. Cognitive functions showed early deterioration with significant improvement at 6 months. Psychiatric problems had an adverse impact on patients' quality of life which raised the importance of psychiatric consultation before and after cardiac surgeries to shorten recovery time.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 94%

Psychiatric disturbances in patients undergoing open-heart surgery

Younes

Amer

Fawzy

et al. 2019

Middle East Curr Psychiatry

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“…При тяжелых соматических заболеваниях нередко развиваются различные психические расстройства: астенические, неврозоподобные состояния, депрессии, психозы. Существует большое количество клинических исследований частоты соматогенного делирия в послеоперационном периоде, при инсульте, а также в остром периоде ИМ [7][8][9][10][11][12]. Среди больных ИБС в 2 раза чаще, чем в общей популяции, встречаются депрессивные расстройства, наличие которых негативно влияет на прогноз [13].…”

Section: оригинальные статьи § введениеunclassified

Dynamics of brain CD68+ and stabilin-1+ macrophage infiltration in patients with myocardial infarction

et al. 2019

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Te aim of the study was to evaluate the temporal dynamics of brain CD68+ and stabilin-1+ macrophage infltration in patients with fatal myocardial infarction (MI) type 1.Materials and Methods. Te study included 31 patients with fatal MI type I. Te control group comprised 10 patients of 18–40 age group who died from injuries incompatible with life. Patients with MI were divided into two groups. Group 1 comprised patients who died during the frst 72 hours of MI, group 2 comprised patients who died on days 4‒28. Macrophage infltration in the brain was assessed by immunohistochemical analysis. We used CD68 as a marker for the cells of the macrophage lineage and stabilin-1 as an M2-like macrophage biomarker.Results. In group 1 the number of brain CD68+ macrophages was signifcantly higher than in the control group. In group 2 the intensity of brain CD68+ cells infltration was lower than in group 1 and higher than in the control group. Tere was a small amount of stabilin-1+ macrophages in the brain of healthy people, as well as of patients who died from MI. Tere were no signifcant diﬀerences in the number of stabilin-1+ cells between group 1 and group 2. Correlation analysis revealed the presence of positive correlation between the number of CD68 + macrophages in the infarct, peri-infarct, and non-infarct areas of the myocardium and the number of CD68+ macrophages in the brain in patients with MI. Tere were not correlations between the number of CD68 + and stabilin-1+ cells and the presence of diabetes mellitus, history of stroke, history of MI, and pre-infarction angina.Conclusion. Te number of brain CD68+ macrophages signifcantly increased during the frst three days of MI. Te number of brain stabilin-1+ macrophages did not increase and did not diﬀer from the control values. We observed a positive correlation between the number of CD68+ macrophages in the brain and myocardium.

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“…Cognitive functions were reported to be mildly or not significantly impaired after transcatheter aortic valve implantation (TAVI) [115]. Postoperative delirium is associated with increased anxiety and depression at 6 to 9 months, and future investigation should seek to evaluate the utility of screening programs for affective disorders in those individuals who develop delirium in the postoperative period [116].…”

Section: Reviewmentioning

confidence: 99%

Best practice in psychological activities in cardiovascular prevention and rehabilitation: Position Paper

Angelino

Porta

Abatello

et al. 2018

Monaldi Arch Chest Dis

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Recent guidelines on cardiovascular disease prevention suggest multimodal behavioral interventions for psychosocial risk factors and referral for psychotherapy in the case of clinically significant symptoms of depression and anxiety overall. Accordingly, psychologists of the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology (GICR-IACPR) have reviewed the key components of psychological activities in cardiovascular prevention and rehabilitation (CPR). The aim of this study was to elaborate a position paper on the best practice in routine psychological activities in CPR based on efficacy, effectiveness and sustainability. The steps followed were: i) a review of the latest international guidelines and position papers; ii) analysis of the evidence-based literature; iii) a qualitative analysis of the psychological services operating in some reference Italian cardiac rehabilitation facilities; iv) classification of the psychological activities in CPR as low or high intensity based on the NICE Guidelines on psychological interventions on anxiety and depression. We confirm the existence of an association between depression, anxiety, social factors, stress, personality and illness onset/outcome and coronary heart disease. Evidence for an association between depression, social factors and disease outcome emerges particularly for chronic heart failure. Some positive psychological variables (e.g., optimism) are associated to illness outcome. Evidence is reported on the impact of psychological activities on 'new' conditions which are now indicated for cardiac rehabilitation: pulmonary hypertension, grown-up congenital heart, end-stage heart failure, implantable cardioverter-defribrillator and mechanical ventricular assist devices, frail and oldest-old patients, and end-of-life care. We also report evidence related to caregivers. The Panel divided evidence-based psychological interventions into: i) low intensity (counseling, psycho-education, self-care, self-management, telemedicine, self-help); or ii) high intensity (individual, couples and/or family and group psychotherapy, such as stress management). The results show that psychotherapy is mainly consisting of cognitive-behavior therapy, interpersonal therapy, and short-term psycho-dynamic therapy. The current data further refine the working tools available for psychological activities in CPR, giving clear directions about the choice of interventions, which should be evidence-based and have at least a minimum standard. This document provides a comprehensive update on new knowledge and new paths for psychologists working in the CPR settings.

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Midterm outcomes after postoperative delirium on cognition and mood in patients after cardiac surgery

Abstract: Postoperative delirium is associated with increased anxiety and depression at 6 to 9 months postcardiac surgery. Future investigation should seek to evaluate the utility of screening programs for affective disorders in those individuals who develop delirium in the postoperative period.

Cited by 30 publications

References 33 publications

Psychiatric disturbances in patients undergoing open-heart surgery

Psychiatric disturbances in patients undergoing open-heart surgery

Dynamics of brain CD68+ and stabilin-1+ macrophage infiltration in patients with myocardial infarction

Best practice in psychological activities in cardiovascular prevention and rehabilitation: Position Paper

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