Key result
Postoperative delirium developed in 3.07% of patients after on-pump CABG and was associated with higher mortality and prolonged intensive care unit stay.
Why the study?
What are the incidence and precipitating factors of delirium after on-pump coronary artery bypass grafting?
Observational (n=1,367)
No
What are the incidence and precipitating factors of delirium after on-pump coronary artery bypass grafting?
Postoperative delirium after on-pump CABG occurs in approximately 3% of patients and is associated with significantly increased mortality and prolonged ICU stay.
Answers are grounded in this paper and cite their sources.
Delirium after on-pump CABG may identify higher-risk patients; leaves open whether prevention reduces mortality.
OBJECTIVE: To analyze large contemporary patient population, undergoing on-pump coronary artery bypass grafting at our institution, and identify the prevalence and precipitating factors of delirium development. DESIGN: Baseline demographics, operative data and postoperative outcomes of 1367 consecutive patients were recorded prospectively and analysed using multivariate logistic regression analysis, to determine independent predictors of postoperative delirium development. RESULTS: Delirium was detected in 42 (3.07%) patients. Eight factors: age more than 65 years, peripheral vascular disease, Euroscore>/=5, preoperative IABP support, postoperative blood product usage and postoperative low cardiac output syndrome were independently predicting delirium development after coronary artery bypass procedures. Postoperative delirium was associated with significantly higher mortality rate (16.6% vs. 3.9%, p=0.013), prolonged mechanical ventilation time (9.2+/-3.1 vs. 5.05+/-7.6, p=0.04) and increased length of intensive care unit stay (6.8+/-4.9 vs. 2.0+/-2.7 days, p=0.001). CONCLUSIONS: Delirium is a dangerous complication, prolonging intensive care unit stay and postoperative mortality. Factors associated with delirium development are advanced age, peripheral vascular disease, diminished cardiac function and blood product usage.
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Norkienė et al. (2007) conducted an observational in Coronary artery disease requiring on-pump CABG (n=1,367). Postoperative delirium vs. No postoperative delirium was evaluated on Mortality rate (p=0.013). Postoperative delirium developed in 3.07% of patients after on-pump CABG and was associated with higher mortality and prolonged intensive care unit stay.
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