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BioMed Research International
Volume 2013 (2013), Article ID 835850, 9 pages
http://dx.doi.org/10.1155/2013/835850
Clinical Study

Complex Assessment of the Incidence and Risk Factors of Delirium in a Large Cohort of Cardiac Surgery Patients: A Single-Center 6-Year Experience

1Department of Cardiac Surgery, Upper Silesia Medical Center, Medical University of Silesia, 47 Ziołowa Street, 40-635 Katowice, Poland
2Department of Anesthesiology and Intensive Care, Upper Silesia Medical Center, 40-635 Katowice, Poland
31st Department of Cardiology, Upper Silesia Medical Center, Medical University of Silesia, 40-635 Katowice, Poland
4Department of Psychiatry and Psychotherapy, Upper Silesia Medical Center, Medical University of Silesia, 40-635 Katowice, Poland
5Department of Biostatistics, Chair of Public Health, Medical University of Silesia, 41-902 Bytom, Poland

Received 10 April 2013; Revised 5 September 2013; Accepted 23 September 2013

Academic Editor: Matthias Thielmann

Copyright © 2013 Łukasz J. Krzych et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Previous reports provided inconsistent data on the occurrence of postoperative delirium and emphasized its considerable impact on outcome. This study sought to evaluate the incidence and predictors of delirium, together with its relation to cerebral ischemia in a large cohort of cardiac surgery patients in a tertiary high-volume center. Methods and Results. Consecutive patients ( ) were prospectively enrolled from 2003 to 2008. Exclusion criteria were history of psychiatric disorders, use of psychoactive drugs, alcohol abuse, and data incompleteness. Finally, 5781 patients were analyzed in terms of 100 perioperative patient-specific and treatment variables. The incidence of postoperative delirium (DSM IV criteria) was 4.1% and it coexisted with cerebral ischemia in 1.1% of patients. In bivariate analysis, 49 variables were significantly linked to postoperative delirium. Multivariate analysis confirmed that delirium was independently associated with postoperative stroke (logistic odds ratio (logOR) = 2.862, ), any blood transfusions (logOR = 4.178, ), age > 65 years (logOR = 2.417, ), carotid artery stenosis (logOR = 2.15, ), urgent/emergent surgery (logOR = 1.982, ), fasting glucose level, intraoperative oxygen partial pressure fluctuations, and hematocrit. Area under ROC curve for the model was 0.8933. Conclusions. Early identification of nonpsychiatric perioperative determinants of delirium facilitates its diagnosis and might help develop preventive strategies to improve long-term outcome after cardiac surgery procedures.