Abstract 12640: Predictors of Delirium After Cardiac Surgery
Objective: To identify predictors of delirium after cardiac surgery and its associated postoperative complications.
Methods: Retrospective study including 542 consecutive patients (p) undergoing cardiac surgery in our institution from January 2012 to February 2013. The presence of delirium was assessed using the Confusion Assessment Method-Intensive Care Unit (CAM-ICU). Predictors of delirium were identified with logistic regression analysis.
Results: The prevalence of delirium after cardiac surgery was 16.6% (90 p). P with delirium were older (66.5 ± 12.6 vs 61.9 ± 12.8 years, p≤0.01) and had less use of statins before surgery (48.9% vs 63.0%, p=0.01). Regarding the surgical procedure, combined cardiac surgeries and thoracic aorta procedures were those that had higher proportion of delirium (23.2% vs 14.6%, p=0.02). Cardiopulmonary bypass (CPB) (138 ± 52.3 vs 124 ± 50.7 min, p=0.02) and aortic cross-clamp (111 ± 43.3 vs 99.2 ± 41.3 min, p=0.02) were longer and the requirement of blood transfusions higher (8.79 ± 13.9 vs 4.66 ± 11.3 U, p=0.01) in p who had delirium. During postoperative period, p with delirium had a higher rate of low cardiac output syndrome (24.4% vs 14.6%, p=0.02), atrial fibrillation (AF) (42.2% vs 21.7%, p≤0.01), prolonged mechanical ventilation (43.2% vs 9.60%, p≤0.01), longer intensive critical unit stay (median 5 vs 2 days, p≤0.01) and longer hospital stay (median 11 vs 7 days, p≤0.01). No difference in mortality was found between p who had delirium and who did not have (4.40% vs 3.80%, p=0.8). The independent predictors of delirium after cardiac surgery identified in a multiple logistic regression analysis were: age (OR 1.05, CI 95%: 1.02-1.07), CPB (OR 1.01, CI 95%: 1.00-1.02) and AF (OR 2.19, CI 95%: 1.25-3.83), while the use of statins before surgery reduced the occurrence of postoperative delirium (OR 0.43, CI 95%: 0.24-0.75).
Conclusions: The development of delirium after cardiac surgery was associated with higher morbidity, longer intensive care unit and hospital stay in our population. The independent predictors of delirium after cardiac surgery were age, CPB and AF while the use of statins before surgery reduced its occurrence.
- © 2013 by American Heart Association, Inc.