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Factors associated with delirium after cardiac surgery: A prospective cohort study


1 Intensivist at Cardiovascular Intensive Care Unit. Instituto de Cardiología – Fundación Cardioinfantil, Colombia
2 Department of Cardiology, Head of the Cardiac Surgical Intensive Care Unit, Instituto de Cardiología – Fundación Cardioinfantil, Colombia

Correspondence Address:
Edgar Hernández-Leiva
Calle 163 A # 13B-60, Bogotá DC, Cundinamarca
Colombia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_43_20

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Year : 2021  |  Volume : 24  |  Issue : 2  |  Page : 183-189

 

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Background: Delirium is a frequent complication after cardiac surgery and is associated with a higher incidence of morbidity and mortality and a prolonged hospital stay. However, knowledge of the variables involved in its occurrence is still limited; therefore, in this study, we evaluated the perioperative risk factors independently associated with this complication. Methods: This study was conducted in a referral tertiary care university hospital with a cardiovascular focus. A total of 311 consecutive adult patients undergoing any type of cardiac surgery were evaluated. The subjects were examined at regular intervals in the postoperative period using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) tool. Results: The incidence of postoperative delirium (PD) was 10%. Among the 18 pre-, intra- and postoperative variables evaluated, the logistic regression analysis showed that low education level, history of diabetes or stroke, type of surgery, prolonged extracorporeal circulation, or red blood cell transfusion in the intra- or postoperative period were independently associated with delirium after cardiac surgery. An increased body mass index was identified as a protective factor. Conclusions: The aforementioned risk factors are significantly and independently associated with the presentation of PD. Because some of these factors can be treated or avoided, the results of this study are highly relevant to reduce the risk of this complication and improve the care of patients undergoing cardiac surgery.






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1 Intensivist at Cardiovascular Intensive Care Unit. Instituto de Cardiología – Fundación Cardioinfantil, Colombia
2 Department of Cardiology, Head of the Cardiac Surgical Intensive Care Unit, Instituto de Cardiología – Fundación Cardioinfantil, Colombia

Correspondence Address:
Edgar Hernández-Leiva
Calle 163 A # 13B-60, Bogotá DC, Cundinamarca
Colombia
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_43_20

Rights and Permissions

Background: Delirium is a frequent complication after cardiac surgery and is associated with a higher incidence of morbidity and mortality and a prolonged hospital stay. However, knowledge of the variables involved in its occurrence is still limited; therefore, in this study, we evaluated the perioperative risk factors independently associated with this complication. Methods: This study was conducted in a referral tertiary care university hospital with a cardiovascular focus. A total of 311 consecutive adult patients undergoing any type of cardiac surgery were evaluated. The subjects were examined at regular intervals in the postoperative period using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) tool. Results: The incidence of postoperative delirium (PD) was 10%. Among the 18 pre-, intra- and postoperative variables evaluated, the logistic regression analysis showed that low education level, history of diabetes or stroke, type of surgery, prolonged extracorporeal circulation, or red blood cell transfusion in the intra- or postoperative period were independently associated with delirium after cardiac surgery. An increased body mass index was identified as a protective factor. Conclusions: The aforementioned risk factors are significantly and independently associated with the presentation of PD. Because some of these factors can be treated or avoided, the results of this study are highly relevant to reduce the risk of this complication and improve the care of patients undergoing cardiac surgery.






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