Profiles of delirium and the clinical outcomes of patients who underwent coronary artery bypass grafting: a prospective study from China

Zhang, Weiying; Hu, Wenlin; Shen, Meifang; Ye, Xiaofei; Huang, Yan; Sun, Yan

doi:10.1111/jocn.13089

Cited by 24 publications

(26 citation statements)

References 33 publications

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“…We chose peak CAM-S as our outcome measure to reflect maximal intensity of delirium; however, other measures might have been chosen (e.g., sum CAM-S [18], see Appendix). Future studies should examine other severity measures, including the Memorial Delirium Assessment Scale, Delirium Rating Scale, and Delirium Index have been associated with increased mortality [43, 44], institutionalization [45, 46], and length of stay [47]. Delirium duration has also been associated with increased death, ventilation time, and intensive care unit stay [48–51].…”

Section: Discussionmentioning

confidence: 99%

Delirium Severity Post-Surgery and its Relationship with Long-Term Cognitive Decline in a Cohort of Patients without Dementia

Vasunilashorn

Fong

Albuquerque

et al. 2017

JAD

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Background: Delirium has been associated with more rapid cognitive decline. However, it is 39 unknown whether increased delirium severity is associated with a higher rate of long-term 40 cognitive decline. 41Objective: To evaluate delirium severity and the presence and rate of cognitive decline over 36 42 months following surgery. Conclusion: Patients with the highest delirium severity experienced the greatest rate of cognitive 59 decline, which exceeds the rate previously observed for patients with dementia, on serial 60 3 neuropsychological testing administered over 3 years, with a dose-response relationship 61 between delirium severity and long-term cognitive decline. 62

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Section: Discussionmentioning

confidence: 99%

Delirium Severity Post-Surgery and its Relationship with Long-Term Cognitive Decline in a Cohort of Patients without Dementia

Vasunilashorn

Fong

Albuquerque

et al. 2017

JAD

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“…For persons over 65 years of age, prevalence is above 30.0%, whilst for persons over 80 years of age, it ranges from 33.5% to 50.0% [3,4,5,6,7,8,9,10,11,12]. More than 80.0% of delirium cases occur one-three days post-surgery and are temporary [13,14]. However, delirium symptoms persist for more than four days in approximately 10.0% of cases [9,14,15].…”

Section: Introductionmentioning

confidence: 99%

“…More than 80.0% of delirium cases occur one-three days post-surgery and are temporary [13,14]. However, delirium symptoms persist for more than four days in approximately 10.0% of cases [9,14,15]. Patients with delirium have temporary symptoms, such as cognitive and physical dysfunction [3,15,16], and also negative outcomes, such as increased hospital stay lengths and mortality rates [6,8,9,10].…”

Section: Introductionmentioning

confidence: 99%

Postoperative Delirium is Associated with Negative Outcomes and Long-Term Mortality in Elderly Koreans: A Retrospective Observational Study

Park

Kim

2019

Medicina

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Background and objectives: Delirium is an acute state that causes confusion and occurs frequently after surgery in elderly patients. Delirium is also related to various clinical complications. With increasing numbers of surgeries performed on elderly Koreans, the number of cases of delirium and associated complications will likely rise. The purpose of the present study was to determine whether postoperative delirium in elderly Korean patients negatively influenced other clinical outcomes and their long-term mortality. Materials and Methods: The medical records of 1016 elderly patients (65 years or older) who underwent major abdominal surgery from January 2014 to December 2016 were retrospectively investigated. To determine long-term mortality, patients were followed for up to 12 months post-operation. Results: Delirium occurred in 194 patients (18.3%). Postoperative delirium was significantly associated with the length of hospital stay (B = 2.72), length of ICU stay (B = 18.78), adverse medical events (OR = 2.26, CI = 1.45–3.52), reoperation (OR = 5.50, CI = 1.66–18.22), ICU readmission (OR = 14.10, CI = 2.97–66.90), medical costs (B = 2473.85), discharge to somewhere other than the patient’s home (OR = 6.01, CI = 3.35–10.76), hospital readmission (OR = 2.73, CI = 1.45–5.14), in-hospital mortality (OR = 3.34, CI = 1.21–9.19), three-month mortality (HR = 3.22, CI = 1.27–8.14), six-month mortality (HR = 2.85, CI = 1.28–6.36), and 12-month mortality (HR = 2.19, CI = 1.10–4.32). Conclusions: Postoperative delirium in elderly Korean patients was associated with negative clinical outcomes and mortality. For rapid recovery and increased survival rates in surgical patients, effective delirium-prevention care and active delirium treatments are necessary.

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“…However, patients who experience hyperactive delirium may display agitation or aggression, which HCPs can recognize more easily 1 . Although hypoactive delirium is difficult to recognize 1 and has poor outcomes, 14 it can be the most common type of delirium that patients experience postoperatively 13,15,16 . To accurately diagnose delirium, HCPs should identify older adult patients’ basic behavioral tendencies before surgery and assess the patients postoperatively for behavior changes.…”

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confidence: 99%

Risk Factors of Postoperative Delirium in Older Adult Spine Surgery Patients: A Meta‐Analysis

Baek¹,

Kim²,

Lee³

2020

AORN Journal

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This literature review identifies factors that may place older adult patients at risk for developing delirium after spine surgery. We conducted a meta-analysis according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Using a variety of electronic databases, we identified five studies for inclusion that represent 645 patients who were 65 years or older. The pooled incidence rate of postoperative delirium was 13.0%. Factors associated with developing postoperative delirium included preoperative opioid use, cervical spine surgery versus lumbar or thoracic spine surgery, spine fusion versus simple spine surgery, hypertension, cerebrovascular disease, pulmonary disease, duration of surgery, and infused IV fluid volume. Nurses who provide perioperative care for older adult patients undergoing spine surgery should be aware of the potential risk factors of delirium to ensure patient safety. Additional research is required to clearly delineate the risk factors for postoperative delirium in older adults.

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Profiles of delirium and the clinical outcomes of patients who underwent coronary artery bypass grafting: a prospective study from China

Abstract: Hospital staff should pay attention to hypoactive delirium, take measures properly to decrease the severity and duration of delirium to improve the results of delirious patients.

Cited by 24 publications

References 33 publications

Delirium Severity Post-Surgery and its Relationship with Long-Term Cognitive Decline in a Cohort of Patients without Dementia

Delirium Severity Post-Surgery and its Relationship with Long-Term Cognitive Decline in a Cohort of Patients without Dementia

Postoperative Delirium is Associated with Negative Outcomes and Long-Term Mortality in Elderly Koreans: A Retrospective Observational Study

Risk Factors of Postoperative Delirium in Older Adult Spine Surgery Patients: A Meta‐Analysis

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