Age- and gender-related peculiarities of patients with delirium in the cardiac intensive care unit

Abstract

A b s t r a c t Background:The overall evidence base regarding delirium has been growing steadily over the past few decades. There has been considerable analysis of delirium concerning, for example, mechanically ventilated patients, patients in the general intensive care unit (ICU) setting, and patients with exclusively postoperative delirium. Nevertheless, there are few studies regarding delirium in a cardiovascular ICU (ICCU) setting and especially scarce literature about the particular features of delirium relating to patient age and gender. Aim:We aimed to determine particular features of delirium not induced by alcohol or other psychoactive substances, relating to patient age and gender in an ICCU setting.Methods: An observational cross-sectional study was conducted to evaluate patients with delirium in a Lithuanian ICCU. From a sample of 19,007 ICCU admissions, 337 (1.8%) had documented delirium diagnosed through liaison and consultation with a psychiatrist and were included in the final analysis. The obtained data was then evaluated and analysed according to patients' gender and four categorised age groups: < 65 years, 65-74 years, 75-84 years, and ≥ 85 years. Results:Female patients who experienced delirium demonstrated a higher prevalence of hypertension, hyponatraemia, heart failure, cardiac rhythm and conduction disorders, myocardial infarction (MI), and dementia. The men, who were on average seven years younger than the women, significantly more often had hypokalaemia, double-or triple-vessel coronary artery disease, and sepsis. Furthermore, MI, ST-segment elevated MI, and Killip class 4 were most frequent amongst patients less than 65 years of age. Moreover, the youngest patient group demonstrated the highest mortality. Conclusions:Our investigation presented a number of associated peculiarities related to gender and age. It was shown that delirium is a severe complication that more often affects men amongst patients < 65 years old and more frequently affects women in the age group of ≥ 85 years. Male patients < 65 years old, who develop delirium should be treated with more caution because they tend to have more serious forms of disorder and a poorer prognosis.

Effect of flurbiprofen axetil on postoperative delirium for elderly patients

“…Regarding the association between gender and cognitive function, there is evidence for a female advantage in episodic memory for verbal information and a male advantage in visuospatial memory TA B L E 2 Factors associated with POD in patients over 70 years in the two groups (Beinhoff, Tumani, Brettschneider, Bittner, & Riepe, 2008). Further analysis revealed that men with a more prevalence of sepsis, coronary artery disease, hyponatremia, and hypokalemia, and women with hypertension, conduction disorders, myocardial infarction, and dementia presented a higher incidence of delirium (Serpytis et al, 2017). However, the frequency of delirium after surgery was similar between women and men in many reports (Hogue, Sundt, Barzilai, Schecthman, & Davila-Roman, 2001).…”

Independencia funcional en la recuperación de pacientes sometidos a cirugía cardiaca.

“…Los pacientes que son sometidos a cirugía cardiaca atraviesan una serie de alteraciones que afectan sus funciones fisiológicas y las motoras y/o cognitivas, lo que conlleva a una disminución en la capacidad para desarrollar las actividades de la vida diaria, generando así, un déficit de autocuidado (21,22). Adicionalmente, la escala utilizada en este estudio es útil para medir el estado funcional de las personas cuando son dadas de alta de un servicio de cuidado intensivo (23).…”

“…Del mismo modo, se evidenció que durante la medición posterior a la cirugía, los pacientes presentaban mayor dependencia para la ejecución de sus actividades de la vida diaria explicado por las limitaciones para la movilización tales como: accesorios de uso terapéutico (sondas, drenes, catéteres, vía aérea artificial), inestabilidad hemodinámica y respiratoria (24). También se debe precisar, que el cuidado intensivo postoperatorio de la cirugía cardíaca, tiene como objetivo la recuperación de la homeostasis que se ve afectada por los cambios fisiopatológicos generados por el uso de la circulación extracorpórea, los fenómenos de isquemia-reperfusión en el corazón, la hipotermia, trastornos en el sistema de coagulación y los efectos adversos de las transfusiones y el sangrado (23,25); por tanto, el reposo en cama puede conllevar al desacondicionamiento físico (26).…”

Analysis of the Incidence and Risk factors of Postoperative Delirium in Patients with Degenerative Cervical Myelopathy

“…There is little research on whether gender affects the occurrence of the POD. According to a study 32 , delirium was more often affected men amongst patients under 65 years old and more frequently affected women in the age group of over 85 movement can also help treat patients, and it is also necessary to create an environment to help patients recover by using the items needed for each patient.…”