Psychiatric Complications of Open-Heart Surgery

Clinical observation suggested that the prevalence and severity of postcardiotomy delirium had declined in recent years. It was reasoned that a comparative analysis of a current with an earlier sample would document this decline and perhaps shed further light on the etiology of the delirium. In 67 per cent mental status remained clear. The frequency of delirium preceded by a lucid postoperative interval declined from 38 per cent in 1965 to 24 per cent in 1969. In 9 per cent there was an immediate organic brain syndrome. The following factors, evidently associated with brain dysfunction, were found to be related to the occurrence of delirium: advanced age, severity of preoperative and postoperative illness and time on cardiopulmonary bypass. The postoperative lucid interval suggested that recovery-room factors were also involved. Decreased time required on cardiopulmonary bypass appears to be a primary factor in the reduction of frequency. Modifications in the environment of the recovery room after open-heart surgery may also have contributed to the decline.