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
Koster et al.12 recorded 6-month mortality and hospital readmission rates in 300 cardiac surgery patients. Patients were screened daily in the hospital for delirium. Patients who suffered delirium during their hospitalization had higher mortality at 6 months (OR=5.1 after correction for age, P=0.011) and were more likely to be readmitted to the hospital (OR=2.16 after correction for age, P=0.028).
Magusan et al.14 retrospectively reviewed the medical records of 656 cardiac surgery patients who had been screened postoperatively for delirium. Investigators evaluated the influence of postoperative delirium on patient outcome. After adjusting for patient, procedure, and treatment factors, patients with delirium were 4.31 times more likely to be discharged to a nursing facility, 3.35 times more likely to utilize physical therapy, 2.64 times more likely to required home health services and stayed 1.38 times longer in the hospital.
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.