Recognise postoperative delirium in time

Cardiovascular surgery patients may be at increased risk for postoperative delirium([FOOTNOTE=Smulter N, Lingehall HC, Gustafson Y, Olofsson B, Engstrom KG. Delirium after cardiac surgery: incidence and risk factors. Interact Cardiovasc Thorac Surg. 2013;17(5):790-796],[ANCHOR=],[LINK=]).

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INCIDENCE OF POSTOPERATIVE DELIRIUM BY CARDIOVASCULAR SURGICAL PROCEDURE

High, low, and mean incidence of postoperative delirium by cardiac surgical procedure.

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Brown 2016

Brown et al.([FOOTNOTE=Brown CHt, Laflam A, Max L, et al. The Impact of Delirium After Cardiac Surgical Procedures on Postoperative Resource Use. Ann Thorac Surg. 2016;101(5):1663-1669.],[ANCHOR=],[LINK=]) postoperatively evaluated 66 cardiac surgery patients for postoperative delirium. For each patient, ICU length of stay, hospital length of stay, and hospital charges were recorded.  Outcomes were compared using rank sum testing or propensity matching. All three endpoints were significantly greater in patients with delirium. A propensity score model adjusted for patient related and surgical characteristics also found the patients with delirium has greater median hospital charges by $10,339 (p=0.02) and greater ICU-LOS by 37.2 hours (P<0.001).

Median hospital and ICU length of stay (LOS) among patients with and without delirium

Median hospital charges in cardiac surgical patients with and without postoperative delirium

REDUCING THE RISK OF POSTOPERATIVE DELIRIUM VIA BIS™-GUIDED ANESTHESIA IN CARDIAC SURGERY PATIENTS

Soehle 2015

Soehle et al.([FOOTNOTE=Soehle M, Dittmann A, Ellerkmann RK, Baumgarten G, Putensen C, Guenther U. Intraoperative burst suppression is associated with postoperative delirium following cardiac surgery: a prospective, observational study. BMC Anesthesiol. 2015;15:61.],[ANCHOR=],[LINK=]) prospectively recorded pre-, intra, and postoperative EEG variables (BIS™ brain monitoring, EEG asymmetry, and burst suppression) via a bilateral BIS™ monitor in 81 cardiac surgery patients.  Postoperatively, patients were screened for delirium via the CAM-ICU.  Patients who were identified with delirium had a significantly longer duration of burst suppression.

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