Factors associated with intensive care unit delirium in patients with acute myocardial infarction

Aono-Setoguchi, Hitomi; Sakakura, Kenichi; Jinnouchi, Hiroyuki; Taniguchi, Yousuke; Tsukui, Takunori; Watanabe, Yûsuke; Yamamoto, Kei; Seguchi, Masaru; Wada, Hiroshi; Fujita, Hideo

doi:10.1007/s00380-022-02200-1

Cited by 7 publications

(3 citation statements)

References 43 publications

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“…On the other hand, delirium is a neuropsychiatric characterized by an acute change in attention and other aspects of cognition such as altered arousal, disorientation, psychosis, or mood disturbance. The incidence of delirium in Intensive Care Unit (ICU) after acute MI is around 30%, and it is associated with several poor outcomes such as a longer hospital stay, functional decline, falls, incident dementia, and higher in-hospital death [71][72][73]. The risk of delirium is determined by predisposing factors (pre-existing conditions that confer vulnerability to patients) and precipitating factors (conditions that trigger the development of this syndrome).…”

Section: Cognitive Impairment and Deliriummentioning

confidence: 99%

The Impact of Geriatric Conditions in Elderly Patients with Coronary Heart Disease: A State-of-the-Art Review

Alonso Salinas,

Cepas-Guillén,

León

et al. 2024

JCM

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The growing geriatric population presenting with coronary artery disease poses a primary challenge for healthcare services. This is a highly heterogeneous population, often underrepresented in studies and clinical trials, with distinctive characteristics that render them particularly vulnerable to standard management/approaches. In this review, we aim to summarize the available evidence on the treatment of acute coronary syndrome in the elderly. Additionally, we contextualize frailty, comorbidity, sarcopenia, and cognitive impairment, common in these patients, within the realm of coronary artery disease, proposing strategies for each case that may assist in therapeutic approaches.

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Section: Cognitive Impairment and Deliriummentioning

confidence: 99%

The Impact of Geriatric Conditions in Elderly Patients with Coronary Heart Disease: A State-of-the-Art Review

Alonso Salinas,

Cepas-Guillén,

León

et al. 2024

JCM

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“…We used the laboratory data at admission. Since we could not measure some laboratory data such as HbA1c or lowdensity lipoprotein (LDL) cholesterol levels at off hours (night or holidays), we substituted the earliest HbA1c or LDL cholesterol levels since admission for the laboratory data at admission 35) . Left ventricular ejection fraction (LVEF) was measured using transthoracic echocardiography during the index hospitalization.…”

Section: Definitionsmentioning

confidence: 99%

Impact of the Japanese Version of High Bleeding Risk Criteria on Clinical Outcomes in Patients with ST-segment Elevation Myocardial Infarction

Konoma,

Sakakura,

Jinnouchi

et al. 2024

JAT

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Aims: Bleeding complications are often observed in patients with ST-segment elevation myocardial infarction (STEMI). Although the Japanese version of the high bleeding risk criteria (J-HBR) were established, it has not been sufficiently validated in patients with STEMI. This retrospective study aims to examine whether J-HBR is associated with cardiovascular and bleeding events in patients with STEMI. Methods: We included 897 patients with STEMI and divided them into the J-HBR group ( n =567) and the non-J-HBR group ( n =330). The primary endpoint was the major adverse cardiovascular events (MACE), defined as the composite of all-cause death, non-fatal myocardial infarction, ischemic stroke, and systemic embolism. Another primary endpoint was total bleeding events defined as type 3 or 5 bleeding events as defined by the Bleeding Academic Research Consortium . Results: During the median follow-up duration of 573 days, 187 MACE and 141 total bleeding events were observed. The Kaplan–Meier curves showed that MACE and total bleeding events were more frequently observed in the J-HBR group than in the non-J-HBR group ( p ＜0.001). Multivariate Cox hazard analysis revealed that after controlling for multiple confounding factors, the J-HBR group was significantly associated with MACE (hazard ratio [HR] 4.676, 95% confidence interval (CI) 2.936–7.448, p ＜0.001) and total bleeding events (HR 6.325, 95% CI 3.376–11.851, p ＜0.001). Conclusions: J-HBR is significantly associated with MACE and total bleeding events in patients with STEMI. This study validated J-HBR as a risk marker for bleeding events and suggests J-HBR as a potential risk marker for MACE in patients with STEMI.

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“…AMI was defined according to the universal definition [10]. Diagnostic ST elevation was defined as new ST elevation at the J point in at least two contiguous leads of 2 mm (0.2 mV), and the AMI patients with ST elevation were diagnosed as STEMI [11,12]. The definitions of hypertension, diabetes mellitus, and dyslipidemia were described elsewhere [13,14].…”

Section: Definitionsmentioning

confidence: 99%

Impact of Excessive Increase in Systolic Blood Pressure after Exercise on Clinical Outcomes in Patients with ST-Segment Elevation Myocardial Infarction

Yamashita,

Sakakura,

Jinnouchi

et al. 2023

JCM

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Objective: Although the clinical outcomes for patients with ST-elevation myocardial infarction (STEMI) have improved significantly, some patients still experience poor clinical outcomes. The available risk classifications focus on the short-term outcomes, and it remains important to find high-risk features among patients with STEMI. In Japan, the 200 m walk electrocardiogram (ECG) test is widely performed before discharge. The purpose of this study was to investigate the association between the excessive increase in systolic blood pressure (SBP) following a 200 m walk and the long-term clinical outcomes in patients with STEMI. Methods: We included 680 patients with STEMI and divided those into an excessive increase in SBP group (n = 144) and a non-excessive increase in SBP group (n = 536) according to the SBP increase after a 200 m walk ECG test. We defined an excessive increase in SBP as SBP ≥ 20 mmHg either just after or 3 min after a 200 m walk ECG test. The primary endpoint consisted of major cardiovascular events (MACE), defined as the composite of all-cause death, non-fatal myocardial infarction, readmission for heart failure, and ischemia-driven target vessel revascularization. Results: The median follow-up duration was 831 days. MACE was more frequently observed in the excessive increase in SBP group (24.3%) than in the non-excessive increase in SBP group (15.1%). Multivariate Cox hazard analysis revealed that the excessive increase in SBP was significantly associated with MACE (HR 1.509, 95% CI: 1.005–2.267, p = 0.047) after controlling for multiple confounding factors. Conclusion: An excessive increase in SBP after the 200 m walk ECG test was significantly associated with MACE in patients with STEMI. The 200 m walk ECG test is simple and low-cost, but may help to identify high-risk patients with STEMI.

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Factors associated with intensive care unit delirium in patients with acute myocardial infarction

Cited by 7 publications

References 43 publications

The Impact of Geriatric Conditions in Elderly Patients with Coronary Heart Disease: A State-of-the-Art Review

The Impact of Geriatric Conditions in Elderly Patients with Coronary Heart Disease: A State-of-the-Art Review

Impact of the Japanese Version of High Bleeding Risk Criteria on Clinical Outcomes in Patients with ST-segment Elevation Myocardial Infarction

Impact of Excessive Increase in Systolic Blood Pressure after Exercise on Clinical Outcomes in Patients with ST-Segment Elevation Myocardial Infarction

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