| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
J Thorac Cardiovasc Surg 2004;127:57-64
© 2004 The American Association for Thoracic Surgery
Cardiopulmonary support and physiology |
a Department of Cardiac Surgery, Heart Center, University of Leipzig, Leipzig, Germany
Received for publication December 31, 2002; revisions received June 10, 2003; accepted for publication July 14, 2003.
* Address for reprints: Jan Bucerius, MD, University of Leipzig, Heart Center, Department of Cardiac Surgery, Strümpellstr. 39, D-04289 Leipzig, Germany
bucerj{at}medizin.uni-leipzig.de
BACKGROUND: Despite improved outcomes after cardiac operations, postoperative delirium remains a common complication that is associated with increased morbidity and prolonged hospital stay.
METHODS: Univariate and multivariate predictors of postoperative delirium were determined from prospectively gathered data on 16,184 patients undergoing cardiac operations with cardiopulmonary bypass (conventional, n = 14,342) and without cardiopulmonary bypass (beating-heart surgery, n = 1847) between April 1996 and August 2001. Delirium was defined as a transient mental syndrome of acute onset characterized by global impairment of cognitive functions, a reduced level of consciousness, attentional abnormalities, increased or decreased psychomotor activity, and a disordered sleep-wake cycle.
RESULTS: The overall prevalence of postoperative delirium was 8.4%. Of 49 selected patient-related risk factors and treatment variables, 35 were highly associated with postoperative delirium by univariate analysis. Stepwise logistic regression revealed the following variables as independent predictors of delirium: history of cerebrovascular disease, peripheral vascular disease, atrial fibrillation, diabetes mellitus, left ventricular ejection fraction of 30% or less, preoperative cardiogenic shock, urgent operation, intraoperative hemofiltration, operation time of 3 hours or more, and a high perioperative transfusion requirement. Two variables were identified as having a significant protective effect against postoperative delirium: beating-heart surgery and younger patient age.
CONCLUSIONS: Postoperative delirium is a common complication in cardiac operations. The increased use of beating-heart surgery without cardiopulmonary bypass may lead to a lower prevalence of this complication and thus improve patient outcomes.
This article has been cited by other articles:
|
|
 |
|
  M. Banach, G. Mariscalco, M. Ugurlucan, D. P. Mikhailidis, M. Barylski, and J. Rysz The significance of preoperative atrial fibrillation in patients undergoing cardiac surgery: preoperative atrial fibrillation--still underestimated opponent Europace, October 1, 2008; (2008) eun273v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. C. Tan, A. Felde, M. Kuskowski, H. Ward, R. F. Kelly, A. S. Adabag, and M. Dysken Incidence and Predictors of Post-Cardiotomy Delirium Am J Geriatr Psychiatry, July 1, 2008; 16(7): 575 - 583. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Khaladj, M. Shrestha, S. Meck, S. Peterss, H. Kamiya, K. Kallenbach, M. Winterhalter, L. Hoy, A. Haverich, and C. Hagl Hypothermic circulatory arrest with selective antegrade cerebral perfusion in ascending aortic and aortic arch surgery: A risk factor analysis for adverse outcome in 501 patients. J. Thorac. Cardiovasc. Surg., April 1, 2008; 135(4): 908 - 914. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Hedges and N. S. Redeker Comparison of Sleep and Mood in Patients After On-Pump and Off-Pump Coronary Artery Bypass Surgery Am. J. Crit. Care., March 1, 2008; 17(2): 133 - 140. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Kazmierski, M. Kowman, M. Banach, W. Fendler, P. Okonski, A. Banys, R. Jaszewski, T. Sobow, and I. Kloszewska Clinical Utility and Use of DSM-IV and ICD-10 Criteria and The Memorial Delirium Assessment Scale in Establishing a Diagnosis of Delirium After Cardiac Surgery Psychosomatics, February 1, 2008; 49(1): 73 - 76. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. Falk and F. W. Mohr Minimally Invasive Myocardial Revascularization Card. Surg. Adult, January 1, 2008; 3(2008): 697 - 710. [Full Text]
|
|
|
|
 |
|
 G. I. Tagarakis, F. Tsolaki-Tagaraki, M. Tsolaki, A. Diegeler, N. B. Tsilimingas, and A. Papassotiropoulos The Role of Apolipoprotein E in Cognitive Decline and Delirium after Bypass Heart Operations American Journal of Alzheimer's Disease and Other Dementias, July 1, 2007; 22(3): 223 - 228. [Abstract] [PDF]
|
|
|
|
 |
|
 G. J. Murphy and G. D. Angelini Indications for Blood Transfusion in Cardiac Surgery Ann. Thorac. Surg., December 1, 2006; 82(6): 2323 - 2334. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. C. Burgess, M. J. Kilborn, and A. C. Keech Interventions for prevention of post-operative atrial fibrillation and its complications after cardiac surgery: a meta-analysis Eur. Heart J., December 1, 2006; 27(23): 2846 - 2857. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. J. Giltay, R. V.H.P. Huijskes, K. H. Kho, B. A. Blansjaar, and P. M.J. Rosseel Psychotic symptoms in patients undergoing coronary artery bypass grafting and heart valve operation. Eur. J. Cardiothorac. Surg., July 1, 2006; 30(1): 140 - 147. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. M. McKhann, M. A. Grega, L. M. Borowicz Jr, W. A. Baumgartner, and O. A. Selnes Stroke and Encephalopathy After Cardiac Surgery: An Update Stroke, February 1, 2006; 37(2): 562 - 571. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Pepper Controversies in Off-pump Coronary Artery Surgery Clin. Med. Res., February 1, 2005; 3(1): 27 - 33. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
