ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
An easily overlooked clinical phenomenon after coronary artery bypass graft surgery: postoperative delirium
Hüseyin Şaşkın1, Kazım Serhan Özcan2, Çağrı Düzyol 1, Hüseyin Maçika3, Rezan Aksoy 1, Mustafa İdiz4
1Departments of Cardiovascular Surgery, Derince Training and Research Hospital, Kocaeli, Turkey
2Departments of Cardiology, Derince Training and Research Hospital, Kocaeli, Turkey
3Departments of Anesthesiology and Reanimation, Acıbadem Hospital, Kocaeli, Turkey
4Departments of Cardiovascular Surgery, Acıbadem Hospital, Kocaeli, Turkey
DOI : 10.5606/tgkdc.dergisi.2016.12278
Background: In this study, we aimed to investigate the prevalence of postoperative delirium in patients undergoing coronary artery bypass grafting and to identify possible risk factors associated with this complication.

Methods: Between January 2009 and December 2013, data of a total of 935 patients (747 males, 188 females; mean age 64.3±8.4 years, range 32 to 86 years) who underwent coronary artery bypass grafting were retrospectively analyzed. The patients were divided into two groups including group 1 patients (n=210) with early postoperative delirium and group 2 patients (n=725) attending to scheduled postoperative follow-up visits.

Results: Delirium was significantly more common in the patients with demographic characteristics such as older age and male sex, history of alcohol intake, preoperative atrial fibrillation, increased creatinine levels, and chronic obstructive pulmonary disease (p<0.05). The mean preoperative and postoperative platelet volume and C-reactive protein levels were higher in group 1 (p=0.0001). The mean aortic cross-clamp and cardiovascular bypass time, intubation time, Acute Physiology and Chronic Health Evaluation II score, and the length of stay in the intensive care unit and hospital were significantly higher in the patients with delirium (p<0.05). Sternum revision (p=0.0001) and new-onset atrial fibrillation (p=0.03) were significantly higher in group 1. Early neurological events were observed in 13 patients (6.2%) in group 1 and in 10 patients (1.4%) in group 2 (p=0.0001). Mortality was observed in 10 patients (4.8%) in group 1 and three patients (0.4%) in group 2, suggesting that the difference was statistically significant (p=0.0001).

Conclusion: Our study results show that complications can be minimized by analyzing the associated risk factors in the development of preoperative, perioperative, and postoperative delirium with a full collaboration with liaison psychiatry in the intensive care unit for the patients who are at risk for delirium.

Keywords : Coronary artery bypass grafting; delirium; morbidity; mortality
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