Prevalence and Risk Factors of Postoperative Delirium in Patients Undergoing Open Heart Surgery in Northwest of Iran

Jodati, Ahmadreza; Safaie, Naser; Raoofi, Mohammadbagher; Ghorbani, Ladan; Ranjbar, Fatemeh; Noorazar, Golamreza; Mosharkesh, Majid

doi:10.5681/jcvtr.2013.021

Cited by 5 publications

(1 citation statement)

References 16 publications

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“…Some studies have indicated that an abnormal in sodium or potassium level might be a contributing factor in postoperative delirium,[ 23 ] but others have reported opposite results. [ 24 ] In our univariate logistic regression analysis, an abnormal calcium level was associated with postoperative delirium, but this could not be identified in a multivariate logistic regression analysis. Among our cases, the most common calcium disorder was hypocalcemia, which was also taken as a risk factor for postoperative delirium in Aldemir et al 's study.…”

Section: Discussionmentioning

confidence: 81%

Risk factors and prevention for postoperative delirium after orthopedic surgery

Wang

Jin

et al. 2021

Indian J Psychiatry

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Background: Postoperative delirium significantly delays the recovery of patients. This study sought to explore the risk factors and to prevent postoperative delirium after orthopedic surgery. Materials and Methods: In the part of retrospective study, 456 cases over 70-year-old that underwent one of three types of orthopedic surgery were included and were defined as the retrospective group. The risk factors of postoperative delirium were analyzed by logistic regression. In the part of prospective study, 86 cases of the same age and the same surgery were included and were defined as the prospective group. Positive interventions were used by shortening the fasting time and increasing the perioperative rehydration. The differences of postoperative delirium incidence between the retrospective group and the prospective group were analyzed. Results: Compared with patients with normal postoperative electrolytes, postoperative creatinine <68.20 μmol/L, and fluid infusion during fasting >119.66 mL/h, postoperative electrolyte disorders (odds ratio [OR]: 2.864; 95% confidence interval [CI]: 1.374, 5.970), postoperative creatinine ≥68.20 μmol/L (OR: 2.660; 95% CI: 1.328, 5.328), and fluid infusion during fasting ≤119.66 mL/h (OR: 2.372; 95% CI: 1.197, 4.704) were the risk factors for postoperative delirium. After positive intervention, the postoperative delirium incidence of the prospective group was 5.8% (5/86), and it was lower than 18.4% (84/456) of the retrospective group ( P < 0.05). Conclusions: Elevated postoperative creatinine, postoperative electrolyte disorders, and lower fluid infusion during fasting were three risk factors for postoperative delirium. By shortening the fasting time and increasing the perioperative rehydration, the incidence of postoperative delirium could be reduced.

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Section: Discussionmentioning

confidence: 81%

Risk factors and prevention for postoperative delirium after orthopedic surgery

Wang

Jin

et al. 2021

Indian J Psychiatry

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Risk and Consequences of Postoperative Delirium in Cardiac Surgery

Sugimura

Sipahi

Mehdiani

et al. 2020

Thorac Cardiovasc Surg

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Background Delirium is a common complication after cardiac surgery that leads to increased costs and worse outcomes. This retrospective study evaluated the potential risk factors and postoperative impact of delirium on cardiac surgery patients. Methods One thousand two hundred six patients who underwent open-heart surgery within a single year were included. Uni- and multivariate analyses of a variety of pre, intra-, and postoperative parameters were performed according to differences between the delirium (D) and nondelirium (ND) groups. Results The incidence of delirium was 11.6% (n = 140). The onset of delirium occurred at 3.35 ± 4.05 postoperative days with a duration of 5.97 ± 5.36 days. There were two important risk factors for postoperative delirium: higher age (D vs. ND, 73.1 ± 9.04 years vs. 69.0 ± 11.1 years, p < 0.001) and longer aortic cross-clamp time (D vs. ND, 69.8 ± 49.9 minutes vs. 61.6 ± 53.8 minutes, p < 0.05). We found that delirious patients developed significantly more frequent postoperative complications, such as myocardial infarction (MI) (D vs. ND, 1.43% [n = 3] vs. 0.28% [n = 2], p = 0.05), cerebrovascular accident (D vs. ND, 10.7% [n = 15] vs. 3.75% [n = 40], p < 0.001), respiratory complications (D vs. ND, 16.4% [n = 23] vs. 5.72% [n = 61], p < 0.001), and infections (D vs. ND, 36.4% [n = 51] vs. 16.0% [n = 170], p < 0.001). The hospital stay was longer in cases of postoperative delirium (D vs. ND, 23.2 ± 13.6 days vs. 17.4 ± 12.8 days, p < 0.001), and fewer patients were discharged home (D vs. ND, 56.0% [n = 65] vs. 66.8% [n = 571], p < 0.001). Conclusions Because the propensity for delirium-related complications is high after cardiac surgery, a practical, preventative strategy should be developed for patients with perioperative risk factors, including higher age and a longer cross-clamp time.

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Hypertension, mitral valve disease, atrial fibrillation and low education level predict delirium and worst outcome after cardiac surgery in older adults

Oliveira

et al. 2018

BMC Anesthesiol

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BackgroundDelirium is a common complication after cardiac surgery in older adult patients. However, risk factors and the influence of delirium on patient outcomes are not well established. We aimed to determine the incidence, predisposing and triggering factors of delirium following cardiac surgery.MethodsOne hundred seventy-three consecutive patients aged ≥60 years were studied. Patients’ characteristics and two cognitive function assessment tests were recorded preoperatively. Perioperative variables were blood transfusion, orotracheal intubation time (OIT), renal dysfunction, and hypoxemia. Delirium was assessed using the Confusion Assessment Method for the Intensive Care Unit. The composite outcome consisted of death, infection, and perioperative myocardial infarction until hospital discharge or 30 days after surgery, and for up to 18 months.ResultsOne hundred six patients (61.27%) were men and the age was 69.5 ± 5.8 years. EuroSCORE II index was 4.06 ± 3.86. Hypertension was present in 75.14%, diabetes in 39.88%, and 30.06% were illiterate. Delirium occurred in 59 patients (34.1%). Education level (OR 0.81, 0.71–0.92), hypertension (OR 2.73, 1.16–6.40), and mitral valve disease (OR 2.93, 1.32–6.50) were independent predisposing factors for delirium, and atrial fibrillation after surgery (OR 2.49, 1.20–5.20) represented the potential triggering factor. Delirium (OR 2.35, 1.20–4.58) and OIT ≥ 900 min (OR 2.50; 1.30–4.80) were independently associated with the composite outcome.ConclusionsIn older adult patients submitted to cardiac surgery, delirium is a frequent complication that is associated with worst outcome. Independent risk factors for delirium included education level, hypertension, mitral valve disease, and atrial fibrillation after cardiac surgery.

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Prevalence and Risk Factors of Postoperative Delirium in Patients Undergoing Open Heart Surgery in Northwest of Iran

Cited by 5 publications

References 16 publications

Risk factors and prevention for postoperative delirium after orthopedic surgery

Risk factors and prevention for postoperative delirium after orthopedic surgery

Risk and Consequences of Postoperative Delirium in Cardiac Surgery

Hypertension, mitral valve disease, atrial fibrillation and low education level predict delirium and worst outcome after cardiac surgery in older adults

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