Postoperative psychiatric disorders in general thoracic surgery: incidence, risk factors and outcomes

Abstract

PPDs are associated with adverse outcomes including a longer hospital stay, and increased morbidity and mortality rates. The identification, detection and elimination of these risk factors are recommended.

Complex Assessment of the Incidence and Risk Factors of Delirium in a Large Cohort of Cardiac Surgery Patients: A Single-Center 6-Year Experience

“…Advanced age, beyond doubt, significantly increases risk of delirium but is also in direct relation with numerous comorbidities (e.g., atrial fibrillation, chronic obstructive lung disease, diabetes, heart failure, renal failure, etc.) which were found to be the predictors of delirium in previous studies [5, 7, 11, 18, 20, 21]. The need for blood transfusion was associated with increased risk of delirium.…”

“…Delirium as the most common example of neurologic injury type 2 represents an acute confusional state affecting from 2 to even 70% of patients undergoing cardiac surgery procedures [4–8]. Numerous studies denoted its association with prolonged hospitalization time in the intensive care unit (ICU) and increased total in-hospital stay [4, 7, 9–13], extended time of mechanical ventilation [13], increased risk of infection (including pneumonia [11–13] and sternal wound infection [4]), decreased health-related quality of life [9], and, most importantly, higher long-term mortality [6]. All of them are associated with greater financial burden on the healthcare system.…”

“…Remarkable variation in the prevalence of delirium requires further investigation. Finally, recently published data on potential predictors of delirium are rather scarce and not supported by large cohort studies [4–7, 9, 11, 18–21]. Complex assessment of delirium helps create a universal and adaptable scoring system to facilitate decision-making in everyday clinical practice in patients with delirium [22].…”

Prevalence and risk factors of postoperative delirium in elderly hip fracture patients

“… 30 An abnormal serum glucose level was one of the causative factors in the development of postoperative psychiatric disorders in patients undergoing general thoracic surgery. 31 A study showed that the initial, mean, and maximal intraoperative blood glucose concentrations were significantly higher in patients experiencing complications including death after cardiac surgery. 32 Another study indicated that intraoperative tight blood glucose control using hyperinsulinaemic normoglycaemia increases delirium after cardiac surgery.…”

Diagnostyka, profilaktyka i leczenie majaczenia po operacjach kardiochirurgicznych — doświadczenia własne

“…Powoduje znaczący wzrost ryzyka powstania powikłań miejscowych (niestabilność mostka) z powodu pobudzenia ruchowego i nieprzestrzegania zaleceń, jak również zwiększenie ryzyka wystąpienia powikłań ogólnych, takich jak zakażenie, niewydolność nerek, niewydolność oddechowa i krążeniowa. Stan ten powoduje przedłużenie okresu hospitalizacji [7][8][9][10][11][12][13]. Śmiertelność po przebytym epizodzie majaczenia jest 2-krotnie większa [13,14].…”