Pre-operative mild cognitive dysfunction predicts risk for post-operative delirium after elective cardiac surgery
| Autor: | Hedda Agüero Torres, Maria Eriksdotter Jönhagen, Dan Lindblom, Jan van der Linden, Graciela Veliz-Reissmüller |
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| Předmět: |
Male
Aging medicine.medical_specialty MEDLINE behavioral disciplines and activities Postoperative Complications Risk Factors mental disorders medicine Dementia Humans Cardiac Surgical Procedures Coronary Artery Bypass Aged Mini–Mental State Examination medicine.diagnostic_test business.industry Incidence (epidemiology) Delirium Cognition medicine.disease Cardiac surgery medicine.anatomical_structure Anesthesia Female Geriatrics and Gerontology medicine.symptom business Cognition Disorders Artery |
| Zdroj: | Karolinska Institutet |
| Popis: | Background and Aims: To identify pre-operative risk factors for delirium in patients undergoing elective cardiac surgery, using clearly defined diagnostic criteria for delirium, and a thorough clinical assessment. Methods: The incidence of post-operative delirium in 107 patients ≥60 years undergoing elective cardiac surgery was calculated. None of the patients included suffered from dementia. Pre-operative cognitive function in all patients was assessed using the Mini Mental State Examination (MMSE) and post-operative delirium was diagnosed using the Confusion Assessment Method (CAM). Post-operative clinical and cognitive assessments were carried out for all patients. Results: Twenty-five patients (23.4%) developed delirium post-operatively. Clinical parameters, including age, gender, co-morbidities, medications, and peri-operative parameters, were similar in patients with and without post-operative delirium. Patients with pre-operative subjective memory complaints and lower MMSE scores, undergoing valve operation or valve + coronary artery bypass grafting (CABG), exhibited an increased risk of developing post-operative delirium. Additionally, delirious patients had a significant decline in post-operative MMSE score compared with the non-delirious ones. Conclusions: The main pre-operative risk factors for post-operative delirium after elective cardiac operations were subjective memory complaints, mild cognitive impairment, and type of cardiac surgery, such as valve procedures. This study suggests that cognitive evaluation should be included in pre-operative assessment. |
| Databáze: | OpenAIRE |
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