Early delirium after cardiac surgery: an analysis of incidence and risk factors in elderly (≥65 years) and very elderly (≥80 years) patients

Early delirium after cardiac surgery: an analysis of incidence and risk factors in elderly (≥65 years) and very elderly (≥80 years) patients

Katarzyna Kotfis,1 Aleksandra Szylińska,2 Mariusz Listewnik,3 Marta Strzelbicka,1 Mirosław Brykczyński,3 Iwona Rotter,2 Maciej Żukowski1 1Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University, Szczecin, Poland; 2Department of Medical Rehabilitation a...

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Autores principales: Kotfis K, Szylińska A, Listewnik M, Strzelbicka M, Brykczyński M, Rotter I, Żukowski M
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2018
Materias:
elderly
age
delirium
cardiac surgery
risk factors
mortality
outcome
Geriatrics
RC952-954.6
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spelling oai:doaj.org-article:dda328d182e3487792b202a242e92fc52021-12-02T06:40:25ZEarly delirium after cardiac surgery: an analysis of incidence and risk factors in elderly (≥65 years) and very elderly (≥80 years) patients1178-1998https://doaj.org/article/dda328d182e3487792b202a242e92fc52018-05-01T00:00:00Zhttps://www.dovepress.com/early-delirium-after-cardiac-surgery-an-analysis-of-incidence-and-risk-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Katarzyna Kotfis,1 Aleksandra Szylińska,2 Mariusz Listewnik,3 Marta Strzelbicka,1 Mirosław Brykczyński,3 Iwona Rotter,2 Maciej Żukowski1 1Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University, Szczecin, Poland; 2Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, Szczecin, Poland; 3Department of Cardiac Surgery, Pomeranian Medical University, Szczecin, Poland Introduction: Postoperative delirium is a common complication of cardiac surgery associated with increased mortality, morbidity, and long-term cognitive dysfunction. The aim of this study was to identify incidence and risk factors of delirium in elderly (≥65 years) and very elderly (≥80 years) patients undergoing major cardiac surgery. Materials and methods: We performed a retrospective cohort analysis of prospectively collected data from a register of the cardiac surgery department of a tertiary referral university hospital between 2014 and 2016. Analysis was performed in two groups, ≥65 years and ≥80 years. Results: We analyzed 1,797 patients ≥65 years, including 230 (7.24%) patients ≥80 years. Delirium was diagnosed in 21.4% (384/1,797) of patients above 65 years, and in 33.5% (77/230) of octogenarians. Early mortality did not differ between patients with and without delirium. Intensive care unit (ICU) stay (p<0.001), hospital stay (p<0.001), and intubation time (p=0.002) were significantly longer in patients undergoing cardiac surgery ≥65 years with delirium. According to multivariable analysis, ≥65 years, age (odds ratio [OR] 1.036, p=0.002), low ejection fraction (OR 1.634, p=0.035), diabetes (1.346, p=0.019), and extracardiac arteriopathy (OR 1.564, p=0.007) were found to be independent predictors of post-cardiac surgery delirium. Postoperative risk factors for developing delirium ≥65 years were atrial fibrillation (1.563, p=0.001), postoperative pneumonia (OR 1.896, p=0.022), elevated postoperative creatinine (OR 1.384, p=0.004), and prolonged hospitalization (OR 1.019, p=0.009). Conclusion: Patients above 65 years of age with postoperative delirium have poorer outcome and are more likely to have prolonged hospitalization and ICU stay, and longer intubation times, but 30-day mortality is not increased. In our study, eight independent risk factors for development of post-cardiac surgery delirium were age, low ejection fraction, diabetes, extracardiac arteriopathy, postoperative atrial fibrillation, pneumonia, elevated creatinine, and prolonged hospitalization time. Keywords: elderly, age, delirium, cardiac surgery, risk factors, mortality, outcomeKotfis KSzylińska AListewnik MStrzelbicka MBrykczyński MRotter IŻukowski MDove Medical Pressarticleelderlyagedeliriumcardiac surgeryrisk factorsmortalityoutcomeGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 13, Pp 1061-1070 (2018)
institution DOAJ
collection DOAJ
language EN
topic elderly
age
delirium
cardiac surgery
risk factors
mortality
outcome
Geriatrics
RC952-954.6
spellingShingle elderly
age
delirium
cardiac surgery
risk factors
mortality
outcome
Geriatrics
RC952-954.6
Kotfis K
Szylińska A
Listewnik M
Strzelbicka M
Brykczyński M
Rotter I
Żukowski M
Early delirium after cardiac surgery: an analysis of incidence and risk factors in elderly (≥65 years) and very elderly (≥80 years) patients
description Katarzyna Kotfis,1 Aleksandra Szylińska,2 Mariusz Listewnik,3 Marta Strzelbicka,1 Mirosław Brykczyński,3 Iwona Rotter,2 Maciej Żukowski1 1Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University, Szczecin, Poland; 2Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, Szczecin, Poland; 3Department of Cardiac Surgery, Pomeranian Medical University, Szczecin, Poland Introduction: Postoperative delirium is a common complication of cardiac surgery associated with increased mortality, morbidity, and long-term cognitive dysfunction. The aim of this study was to identify incidence and risk factors of delirium in elderly (≥65 years) and very elderly (≥80 years) patients undergoing major cardiac surgery. Materials and methods: We performed a retrospective cohort analysis of prospectively collected data from a register of the cardiac surgery department of a tertiary referral university hospital between 2014 and 2016. Analysis was performed in two groups, ≥65 years and ≥80 years. Results: We analyzed 1,797 patients ≥65 years, including 230 (7.24%) patients ≥80 years. Delirium was diagnosed in 21.4% (384/1,797) of patients above 65 years, and in 33.5% (77/230) of octogenarians. Early mortality did not differ between patients with and without delirium. Intensive care unit (ICU) stay (p<0.001), hospital stay (p<0.001), and intubation time (p=0.002) were significantly longer in patients undergoing cardiac surgery ≥65 years with delirium. According to multivariable analysis, ≥65 years, age (odds ratio [OR] 1.036, p=0.002), low ejection fraction (OR 1.634, p=0.035), diabetes (1.346, p=0.019), and extracardiac arteriopathy (OR 1.564, p=0.007) were found to be independent predictors of post-cardiac surgery delirium. Postoperative risk factors for developing delirium ≥65 years were atrial fibrillation (1.563, p=0.001), postoperative pneumonia (OR 1.896, p=0.022), elevated postoperative creatinine (OR 1.384, p=0.004), and prolonged hospitalization (OR 1.019, p=0.009). Conclusion: Patients above 65 years of age with postoperative delirium have poorer outcome and are more likely to have prolonged hospitalization and ICU stay, and longer intubation times, but 30-day mortality is not increased. In our study, eight independent risk factors for development of post-cardiac surgery delirium were age, low ejection fraction, diabetes, extracardiac arteriopathy, postoperative atrial fibrillation, pneumonia, elevated creatinine, and prolonged hospitalization time. Keywords: elderly, age, delirium, cardiac surgery, risk factors, mortality, outcome
format article
author Kotfis K
Szylińska A
Listewnik M
Strzelbicka M
Brykczyński M
Rotter I
Żukowski M
author_facet Kotfis K
Szylińska A
Listewnik M
Strzelbicka M
Brykczyński M
Rotter I
Żukowski M
author_sort Kotfis K
title Early delirium after cardiac surgery: an analysis of incidence and risk factors in elderly (≥65 years) and very elderly (≥80 years) patients
title_short Early delirium after cardiac surgery: an analysis of incidence and risk factors in elderly (≥65 years) and very elderly (≥80 years) patients
title_full Early delirium after cardiac surgery: an analysis of incidence and risk factors in elderly (≥65 years) and very elderly (≥80 years) patients
title_fullStr Early delirium after cardiac surgery: an analysis of incidence and risk factors in elderly (≥65 years) and very elderly (≥80 years) patients
title_full_unstemmed Early delirium after cardiac surgery: an analysis of incidence and risk factors in elderly (≥65 years) and very elderly (≥80 years) patients
title_sort early delirium after cardiac surgery: an analysis of incidence and risk factors in elderly (≥65 years) and very elderly (≥80 years) patients
publisher Dove Medical Press
publishDate 2018
url https://doaj.org/article/dda328d182e3487792b202a242e92fc5
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