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Title: Predictors and Outcomes of Cardiac Surgery-Associated Delirium. A Single Centre Retrospective Cohort Study.
Austin Authors: Jones, Daryl A ;Matalanis, George ;Mårtensson, Johan;Robbins, Raymond J ;Shaw, Margaret;Seevanayagam, Siven ;Cowie, Dean A ;Bellomo, Rinaldo 
Affiliation: Intensive Care Unit, Austin Health, Heidelberg, Victoria, Australia
Department of Cardiac Surgery, Austin Health, Heidelberg, Victoria, Australia
Anaesthesia and Intensive Care Medicine, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
Administrative Informatics, Austin Health, Heidelberg, Victoria, Australia
Cardiothoracic Surgery, Austin Health, Heidelberg, Victoria, Australia
Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia
School of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
Issue Date: 8-Feb-2018 2018
Publication information: Heart, Lung & Circulation 2018; 28(3): 455-463
Abstract: The predictors and independent outcome association of delirium after cardiac surgery are important and yet poorly characterised. We performed a retrospective observational study of cardiac surgery patients between January 2009 and March 2016. We defined delirium using ICD-10 diagnostic codes. Multivariable analysis was conducted to find independent associations between baseline variables, delirium, and key clinical outcomes. We studied 2447 study patients (28.7% female, median age was 66 [IQR 57-74] years). Delirium was coded for in 12.9% of patients overall, and in 22.9% of those aged >75years. Increasing age, Charlson co-morbidity index, admission not from home, peripheral vascular disease, respiratory disease, preoperative atrial fibrillation, duration of cardiopulmonary bypass and nature of surgery were all independent predictors of delirium. Delirium was independently and strongly associated with increased risk of reintubation (OR 8.18 [95% CI 5.24-12.78]), tracheostomy (OR 10.44 [95% CI 5.91-18.45]), and increased length of stay by 113.7 [95% CI 99.7-127.7] ICU hours and 6.95 [95% CI 5.94-7.95] hospital days, but not 30-day mortality (OR 0.78 [95% CI 0.38-1.59]; p=0.5). Delirium is common in cardiac surgery patients and increases with age. Delirium was the strongest predictor of reintubation, need for tracheostomy, and prolongation of intensive care unit (ICU) and hospital length of stay. Delirium prevention and attenuation are a priority in cardiac surgery patients.
DOI: 10.1016/j.hlc.2018.01.007
ORCID: 0000-0001-8739-7896
Journal: Heart, Lung & Circulation
PubMed URL: 29454582
Type: Journal Article
Subjects: Cardiac surgery
Appears in Collections:Journal articles

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