Unraveling the Predictors for Delirium and ICU Stay Duration in Patients with Heart Failure and Reduced Ejection Fraction (HFrEF) Undergoing Coronary Artery Bypass Grafting-A Multicentric Analysis.

Autor:	Rustenbach CJ; Department of Thoracic and Cardiovascular Surgery, German Cardiac Competence Center, Eberhard-Karls-University of Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen, Germany., Reichert S; Department of Thoracic and Cardiovascular Surgery, German Cardiac Competence Center, Eberhard-Karls-University of Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen, Germany., Berger R; Department of Thoracic and Cardiovascular Surgery, German Cardiac Competence Center, Eberhard-Karls-University of Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen, Germany., Schano J; Department of Thoracic and Cardiovascular Surgery, German Cardiac Competence Center, Eberhard-Karls-University of Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen, Germany., Nemeth A; Department of Thoracic and Cardiovascular Surgery, German Cardiac Competence Center, Eberhard-Karls-University of Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen, Germany., Haeberle H; Department of Anesthesiology and Intensive Care Medicine, Eberhard-Karls-University of Tuebingen, 72076 Tuebingen, Germany., Charotte C; Department of Anesthesiology and Intensive Care Medicine, Eberhard-Karls-University of Tuebingen, 72076 Tuebingen, Germany., Caldonazo T; Department of Cardiothoracic Surgery, University Hospital of Jena, Friedrich-Schiller-University, 07747 Jena, Germany., Saqer I; Department of Cardiothoracic Surgery, University Hospital of Jena, Friedrich-Schiller-University, 07747 Jena, Germany., Saha S; Department of Cardiac Surgery, Ludwig-Maximilians-University, 80539 Munich, Germany.; German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, 81377 Munich, Germany., Schnackenburg P; Department of Cardiac Surgery, Ludwig-Maximilians-University, 80539 Munich, Germany.; German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, 81377 Munich, Germany., Djordjevic I; Department of Cardiothoracic Surgery, Heart Center, University of Cologne, 50923 Köln, Germany., Krasivskyi I; Department of Cardiothoracic Surgery, Heart Center, University of Cologne, 50923 Köln, Germany., Wendt S; Department of Cardiothoracic Surgery, Heart Center, University of Cologne, 50923 Köln, Germany., Serna-Higuita LM; Institute for Clinical Epidemiology and Applied Biostatistics, Eberhard-Karls-University of Tuebingen, 72074 Tuebingen, Germany., Doenst T; Department of Cardiothoracic Surgery, University Hospital of Jena, Friedrich-Schiller-University, 07747 Jena, Germany., Hagl C; Department of Cardiac Surgery, Ludwig-Maximilians-University, 80539 Munich, Germany.; German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, 81377 Munich, Germany., Wahlers T; Department of Cardiothoracic Surgery, Heart Center, University of Cologne, 50923 Köln, Germany., Schlensak C; Department of Thoracic and Cardiovascular Surgery, German Cardiac Competence Center, Eberhard-Karls-University of Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen, Germany., Sandoval Boburg R; Department of Thoracic and Cardiovascular Surgery, German Cardiac Competence Center, Eberhard-Karls-University of Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen, Germany.
Jazyk:	angličtina
Zdroj:	Biomedicines [Biomedicines] 2024 Mar 28; Vol. 12 (4). Date of Electronic Publication: 2024 Mar 28.
DOI:	10.3390/biomedicines12040749
Abstrakt:	Objective: This study assesses predictors for postoperative delirium (POD) and ICU stay durations in HFrEF patients undergoing CABG, focusing on ONCAB versus OPCAB surgical methods. Summary Background Data: In cardiac surgery, especially CABG, POD significantly impacts patient recovery and healthcare resource utilization. With varying incidences based on surgical techniques, this study provides an in-depth analysis of POD in the context of HFrEF patients, a group particularly susceptible to this complication. Methods: A retrospective analysis of 572 patients who underwent isolated CABG surgery with a preoperative ejection fraction under 40% was conducted at four German university hospitals. Patients were categorized into ONCAB and OPCAB groups for comparative analysis. Results: Age and Euro Score II were significant predictors of POD. The ONCAB group showed higher incidences of re-sternotomy (OR: 3.37), ECLS requirement (OR: 2.29), and AKI (OR: 1.49), whereas OPCAB was associated with a lower incidence of delirium. Statistical analysis indicated a significant difference in ICU stay durations between the two groups, influenced by surgical complexity and postoperative complications. Conclusions: This study underscores the importance of surgical technique in determining postoperative outcomes in HFrEF patients undergoing CABG. OPCAB may offer advantages in reducing POD incidence. These findings suggest the need for tailored surgical decisions and comprehensive care strategies to enhance patient recovery and optimize healthcare resources.
Databáze:	MEDLINE
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