Cardiac Delirium Index for Predicting the Occurrence of Postoperative Delirium in Adult Patients After Coronary Artery Bypass Grafting

Kacper Lechowicz,1 Aleksandra Szylińska,2 Mariusz Listewnik,3 Sylwester Drożdżal,4 Natalia Tomska,2 Iwona Rotter,2 Katarzyna Kotfis1 1Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University in Szczecin, Szczecin, 70-111, Poland; 2Department of Medical R...

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Autores principales:	Lechowicz K, Szylińska A, Listewnik M, Drożdżal S, Tomska N, Rotter I, Kotfis K
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	delirium pod cam-icu cardiac surgery cabg coronary artery bypass grafting Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/88db31e6b46d45e0b5f29c73a52fd364
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spelling	oai:doaj.org-article:88db31e6b46d45e0b5f29c73a52fd3642021-12-02T18:23:04ZCardiac Delirium Index for Predicting the Occurrence of Postoperative Delirium in Adult Patients After Coronary Artery Bypass Grafting1178-1998https://doaj.org/article/88db31e6b46d45e0b5f29c73a52fd3642021-03-01T00:00:00Zhttps://www.dovepress.com/cardiac-delirium-index-for-predicting-the-occurrence-of-postoperative--peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Kacper Lechowicz,1 Aleksandra Szylińska,2 Mariusz Listewnik,3 Sylwester Drożdżal,4 Natalia Tomska,2 Iwona Rotter,2 Katarzyna Kotfis1 1Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University in Szczecin, Szczecin, 70-111, Poland; 2Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, Szczecin, 71-210, Poland; 3Department of Cardiac Surgery, Pomeranian Medical University in Szczecin, Szczecin, 70-111, Poland; 4Department of Pharmacokinetics and Monitored Therapy, Pomeranian Medical University, Szczecin, 70-111, PolandCorrespondence: Katarzyna KotfisDepartment of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, Szczecin, 70-111, PolandTel +48 91-466-11-44Email katarzyna.kotfis@pum.edu.plBackground: Postoperative delirium (POD) is a serious complication of cardiac surgery. It is an acute neuropsychiatric syndrome. The aim of this study was to analyze the CARDEL Index, composed of advancing age, preoperative glycated hemoglobin and the platelet-to-WBC ratio (PWR) previously described and calculated, using a different patient database, to assess its usefulness as a marker for predicting postoperative delirium after coronary artery by-pass grafting (CABG).Methods: A retrospective analysis of 1098 patients who underwent, isolated CABG procedures between 2017 and 2019 was performed.Results: Within the study group, 164/1098 (14.93%) patients were diagnosed with delirium. Preoperative inflammatory parameters were elevated in patients with delirium: White Blood Cell count (p=0.003), Neutrophil count (p=0.016) and C-reactive protein (p< 0.001). A decrease in preoperative PWR was shown in patients with delirium (p=0.008). Delirious patients spent more time mechanically ventilated (p< 0.001) and had longer hospitalization times (p=0.002). Mortality at 1 year was significantly higher in patients with POD (p< 0.001). The CARDEL Index in this study group for POD detection has the largest area under the curve (AUC) of 0.664 (p< 0.001) and a cut-off value of 8.08.Conclusion: CARDEL Index may be treated as a potentially valuable tool for delirium prediction in patients after CABG.Keywords: delirium, POD, CAM-ICU, cardiac surgery, CABG, coronary artery bypass graftingLechowicz KSzylińska AListewnik MDrożdżal STomska NRotter IKotfis KDove Medical Pressarticledeliriumpodcam-icucardiac surgerycabgcoronary artery bypass graftingGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 16, Pp 487-495 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	delirium pod cam-icu cardiac surgery cabg coronary artery bypass grafting Geriatrics RC952-954.6
spellingShingle	delirium pod cam-icu cardiac surgery cabg coronary artery bypass grafting Geriatrics RC952-954.6 Lechowicz K Szylińska A Listewnik M Drożdżal S Tomska N Rotter I Kotfis K Cardiac Delirium Index for Predicting the Occurrence of Postoperative Delirium in Adult Patients After Coronary Artery Bypass Grafting
description	Kacper Lechowicz,1 Aleksandra Szylińska,2 Mariusz Listewnik,3 Sylwester Drożdżal,4 Natalia Tomska,2 Iwona Rotter,2 Katarzyna Kotfis1 1Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University in Szczecin, Szczecin, 70-111, Poland; 2Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, Szczecin, 71-210, Poland; 3Department of Cardiac Surgery, Pomeranian Medical University in Szczecin, Szczecin, 70-111, Poland; 4Department of Pharmacokinetics and Monitored Therapy, Pomeranian Medical University, Szczecin, 70-111, PolandCorrespondence: Katarzyna KotfisDepartment of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, Szczecin, 70-111, PolandTel +48 91-466-11-44Email katarzyna.kotfis@pum.edu.plBackground: Postoperative delirium (POD) is a serious complication of cardiac surgery. It is an acute neuropsychiatric syndrome. The aim of this study was to analyze the CARDEL Index, composed of advancing age, preoperative glycated hemoglobin and the platelet-to-WBC ratio (PWR) previously described and calculated, using a different patient database, to assess its usefulness as a marker for predicting postoperative delirium after coronary artery by-pass grafting (CABG).Methods: A retrospective analysis of 1098 patients who underwent, isolated CABG procedures between 2017 and 2019 was performed.Results: Within the study group, 164/1098 (14.93%) patients were diagnosed with delirium. Preoperative inflammatory parameters were elevated in patients with delirium: White Blood Cell count (p=0.003), Neutrophil count (p=0.016) and C-reactive protein (p< 0.001). A decrease in preoperative PWR was shown in patients with delirium (p=0.008). Delirious patients spent more time mechanically ventilated (p< 0.001) and had longer hospitalization times (p=0.002). Mortality at 1 year was significantly higher in patients with POD (p< 0.001). The CARDEL Index in this study group for POD detection has the largest area under the curve (AUC) of 0.664 (p< 0.001) and a cut-off value of 8.08.Conclusion: CARDEL Index may be treated as a potentially valuable tool for delirium prediction in patients after CABG.Keywords: delirium, POD, CAM-ICU, cardiac surgery, CABG, coronary artery bypass grafting
format	article
author	Lechowicz K Szylińska A Listewnik M Drożdżal S Tomska N Rotter I Kotfis K
author_facet	Lechowicz K Szylińska A Listewnik M Drożdżal S Tomska N Rotter I Kotfis K
author_sort	Lechowicz K
title	Cardiac Delirium Index for Predicting the Occurrence of Postoperative Delirium in Adult Patients After Coronary Artery Bypass Grafting
title_short	Cardiac Delirium Index for Predicting the Occurrence of Postoperative Delirium in Adult Patients After Coronary Artery Bypass Grafting
title_full	Cardiac Delirium Index for Predicting the Occurrence of Postoperative Delirium in Adult Patients After Coronary Artery Bypass Grafting
title_fullStr	Cardiac Delirium Index for Predicting the Occurrence of Postoperative Delirium in Adult Patients After Coronary Artery Bypass Grafting
title_full_unstemmed	Cardiac Delirium Index for Predicting the Occurrence of Postoperative Delirium in Adult Patients After Coronary Artery Bypass Grafting
title_sort	cardiac delirium index for predicting the occurrence of postoperative delirium in adult patients after coronary artery bypass grafting
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/88db31e6b46d45e0b5f29c73a52fd364
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Cardiac Delirium Index for Predicting the Occurrence of Postoperative Delirium in Adult Patients After Coronary Artery Bypass Grafting

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