Psychological Adjustment Following Open-Heart Surgery

Weiss, Stephen M.

doi:10.1097/00005053-196610000-00007

Cited by 28 publications

(10 citation statements)

References 43 publications

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“…Six studies that used selected patient samples or samples gathered both retrospectively and prospectively were excluded [15,21,24,29,47,56]. This yielded a total of 16 prospective [6,10,17,19,22,23,30,33,36,39,40,42,44,45,53,55] and 3 retrospective [8,40,46] studies for further research and analysis of the overall incidence of postcardiotomy delirium and possible risk factors. Figure 1 shows the incidences of delirium reported in the 16 prospective and 3 retrospective selected studies.…”

Section: Resultsmentioning

confidence: 99%

Delirium after cardiac surgery: A critical review

Mast¹,

Roest

1996

Journal of Psychosomatic Research

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Numerous articles have been published investigating the incidence of and risk factors for delirium after cardiac surgery. Smith and Dimsdale reviewed the literature on postcardiotomy delirium in 1987 using a meta-analysis of 44 research studies. However, doubts about their methods and results caused the authors to re-examine the literature using these 44 references as well as computerized literature searches to gather research and review papers from medical journals. Delirium after cardiac surgery appeared to be ill-defined in most of these studies. The methods and instruments used to assess delirium proved to be very different, and the patient samples were rather heterogeneous. Therefore, in most cases, the results are not comparable. Only a small number of the studies that were examined fit the criteria for statistical meta-analysis. On the basis of our analysis, a tentative conclusion may be drawn that the incidence of postcardiotomy delirium has declined slightly and that no strong risk factors have yet been identified.

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Section: Resultsmentioning

confidence: 99%

Delirium after cardiac surgery: A critical review

Mast¹,

Roest

1996

Journal of Psychosomatic Research

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“…[ 21 ] Delirium rates up to 90% have been reported in operations that required replacement of both the mitral and aortic valves. [ 19 22 ] While several studies have suggested that avoiding CPB altogether decreases the incidence of psychiatric and neurological complications postoperatively,[ 23 24 ] no difference has been found between on-pump and off-pump CABG. [ 25 26 ] For procedures requiring complex aortic reconstruction or deep hypothermic circulatory arrest, the incidence of delirium has been described in a range of 5–30%.…”

Section: Risk Factors For Delirium In the Cardiac Surgical Intensive mentioning

confidence: 99%

“…It has been shown that patients who demonstrate a low cardiac output during the first several postoperative days experienced hallucinations. [ 22 24 ] Interestingly, these symptoms present when a rapid rise in cardiac output occurs. One study showed that the use of an intra-aortic balloon pump (IABP) correlated with an increased risk of delirium.…”

Section: Risk Factors For Delirium In the Cardiac Surgical Intensive mentioning

confidence: 99%

Current approach to diagnosis and treatment of delirium after cardiac surgery

Evans¹,

Weiner²,

Arora³

et al. 2016

Ann Card Anaesth

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Delirium after cardiac surgery remains a common occurrence that results in significant short- and long-term morbidity and mortality. It continues to be underdiagnosed given its complex presentation and multifactorial etiology; however, its prevalence is increasing given the aging cardiac surgical population. This review highlights the perioperative risk factors, tools to assist in diagnosing delirium, and current pharmacological and nonpharmacological therapy options.

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“…Although some of the earliest cognitive outcomes studies did include control groups, 3,4 the trend for later studies was to measure within-subject changes in only the patients having surgery. This may have been partially because of the difficulty in finding a control group that matched the CABG surgery group in important respects.…”

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confidence: 99%

Neurocognitive complications after coronary artery bypass surgery

Selnes

McKhann

2005

Annals of Neurology

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Both short- and long-term cognitive changes continue to occur after coronary artery bypass grafting (CABG), but the pathophysiology of these neurobehavioral changes remains incompletely understood. The persistence of mild postoperative neurocognitive changes despite multiple improvements in the cardiopulmonary bypass procedure may be partially because of surgical populations being older and having more prevalent comorbid disease. The cause of the early postoperative changes is most likely multifactorial and may include ischemic injury from microemboli, hypoperfusion, and other factors resulting from major surgery. Several lines of evidence suggest that the late cognitive decline between 1 and 5 years after surgery may be secondary to high rates of cerebrovascular disease among candidates for CABG. A history of hypertension and other risk factors for vascular disease is known to be associated with increased risk for long-term cognitive decline in community-dwelling elderly individuals. Cerebrovascular risk factors are also associated with silent magnetic resonance imaging abnormalities in patients undergoing CABG. Thus, whereas both short- and long-term postoperative cognitive changes have been associated with CABG, only the short-term, transient changes appear to be directly related to the use of cardiopulmonary bypass.

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Psychological Adjustment Following Open-Heart Surgery

Cited by 28 publications

References 43 publications

Delirium after cardiac surgery: A critical review

Delirium after cardiac surgery: A critical review

Current approach to diagnosis and treatment of delirium after cardiac surgery

Neurocognitive complications after coronary artery bypass surgery

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