Tafelmeier, Maria and Knapp, Marvin and Lebek, Simon and Floerchinger, Bernhard and Camboni, Daniele and Creutzenberg, Marcus and Wittmann, Sigrid and Zeman, Florian and Schmid, Christof and Maier, Lars Siegfried and Wagner, Stefan and Arzt, Michael (2019) Predictors of delirium after cardiac surgery in patients with sleep disordered breathing. EUROPEAN RESPIRATORY JOURNAL, 54 (2): 1900354. ISSN 0903-1936, 1399-3003
Full text not available from this repository. (Request a copy)Abstract
Introduction: Delirium ranks among the most common complications after cardiac surgery. Although various risk factors have been identified, the association between sleep disordered breathing (SDB) and delirium has barely been examined so far. Here, our objectives were to determine the incidence of post-operative delirium and to identify the risk factors for delirium in patients with and without SDB. Methods: This subanalysis of the ongoing prospective observational study CONSIDER-AF (ClinicalTrials.gov identifier NCT02877745) examined risk factors for delirium in 141 patients undergoing cardiac surgery. The presence and type of SDB were assessed with a portable SDB monitor the night before surgery. Delirium was prospectively assessed with the validated Confusion Assessment Method for the Intensive Care Unit on the day of extubation and for a maximum of 3 days. Results: Delirium was diagnosed in 23% of patients: in 16% of patients without SDB, in 13% with obstructive sleep apnoea and in 49% with central sleep apnoea. Multivariable logistic regression analysis showed that delirium was independently associated with age >= 70 years (OR 5.63, 95% CI 1.79-17.68; p=0.003), central sleep apnoea (OR 4.99, 95% CI 1.41-17.69; p=0.013) and heart failure (OR 3.3, 95% CI 1.06-10.35; p=0.039). Length of hospital stay and time spent in the intensive care unit/intermediate care setting were significantly longer for patients with delirium. Conclusions: Among the established risk factors for delirium, central sleep apnoea was independently associated with delirium. Our findings contribute to identifying patients at high risk of developing post-operative delirium who may benefit from intensified delirium prevention strategies.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | POSTOPERATIVE DELIRIUM; COGNITIVE IMPAIRMENT; PRACTICE GUIDELINES; RISK; APNEA; ASSOCIATION; PREVALENCE; PREVENTION; MANAGEMENT; IMPACT; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Lehrstuhl für Innere Medizin II Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 01 Apr 2020 12:07 |
| Last Modified: | 01 Apr 2020 12:07 |
| URI: | https://pred.uni-regensburg.de/id/eprint/26501 |
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