Preoperative Anxiety and Depression Increases the Incidence of Delirium After Coronary Artery Bypass Graft Surgery

Pakrad, Fatemeh; Pakrad, Elham; Darvishi, Nahid; Poorolajal, Jalal

doi:10.1016/j.jopan.2020.01.017

Cited by 12 publications

(12 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Preoperative depression is common in patients with delirium, and depression is a recognized sequel in patients with delirium. Depression and delirium share similar risk factors and pathophysiological mechanisms, including disturbed physiological responses and monoaminergic and melatonin function 43 . However, we did not conclude that pain or anxiety/depression influenced the association between smoking and delirium in this study by mediating analysis by linear regression.…”

Section: Discussioncontrasting

confidence: 75%

Cigarette smoking is linked to an increased risk of delirium following arthroplasty in patients suffering from osteoarthritic pain

Chen

et al. 2023

CNS Neurosci Ther

View full text Add to dashboard Cite

AimsPostoperative delirium (POD) is a common postoperative complication, and the potential relationship between cigarette smoking and POD is still unclear. The current study evaluated the relationship between preoperative smoking status in patients suffering from osteoarthritic pain and POD after total knee arthroplasty (TKA).MethodsA total of 254 patients who had undergone unilateral TKA were enrolled between November 2021 and December 2022, with no gender limitation. Preoperatively, patients' visual analog scale (VAS) scores at rest and during movement, hospital anxiety and depression (HAD) scores, pain catastrophizing scale (PCS) scores and smoking status were collected. The primary outcome was the incidence of POD, which was evaluated by the confusion assessment method (CAM).ResultsA total of 188 patients had complete datasets for final analysis. POD was diagnosed in 41 of 188 patients (21.8%) who had complete data for analysis. The incidence of smoking was significantly higher in Group POD than in Group Non‐POD (22 of 41 patients [54%] vs. 47 of 147 patients [32%], p < 0.05). The postoperative hospital stays were also longer than those of Group Non‐POD (p < 0.001). Multiple logistic regression analysis showed that preoperative smoking (OR: 4.018, 95% CI: 1.158–13.947, p = 0.028) was a risk factor for the occurrence of POD in patients with TKA. The length of hospital stay was correlated with the occurrence of POD.ConclusionsOur findings suggest that patients who smoked preoperatively were at increased risk of developing POD following TKA.

show abstract

Section: Discussioncontrasting

confidence: 75%

Cigarette smoking is linked to an increased risk of delirium following arthroplasty in patients suffering from osteoarthritic pain

Chen

et al. 2023

CNS Neurosci Ther

View full text Add to dashboard Cite

show abstract

“…A previous prospective cohort study could find no link between preoperative anxiety and delirium onset after cardiac surgery 5 . However, the results of a more recent study suggest that anxiety and depression before coronary artery bypass graft surgery significantly increases the incidence of postoperative delirium 8 …”

Section: Introductionmentioning

confidence: 95%

“…5 However, the results of a more recent study suggest that anxiety and depression before coronary artery bypass graft surgery significantly increases the incidence of postoperative delirium. 8 According to Folkman and Lazarus' stress coping theory, a stress response is determined by how an individual perceives the meaning and importance of a particular stressor. 9 Preoperative anxiety, a common stress reaction to impending surgery, is likely linked to individual personality traits and coping processes, which might be associated with the conflicted results of previous studies.…”

Section: Introductionmentioning

confidence: 99%

“…9 Preoperative anxiety, a common stress reaction to impending surgery, is likely linked to individual personality traits and coping processes, which might be associated with the conflicted results of previous studies. 5,8 In the present study, we investigated the relationship between preoperative anxiety and delirium onset after cardiovascular surgery in elderly patients (aged 65 years or older), considering the individual psychological characteristics, such as personality and stress coping skills in response to anxiety, as confounding factors.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Relationship between preoperative anxiety and onset of delirium after cardiovascular surgery in elderly patients: focus on personality and coping process

et al. 2022

View full text Add to dashboard Cite

Background Postoperative delirium is associated with increased mortality. Therefore, it is important to manage delirium during the entire perioperative period. Preoperative anxiety is associated with poor prognosis in postoperative patients who have undergone cardiovascular surgery. This study aims to investigate the relationship between preoperative anxiety and onset of delirium after cardiovascular surgery in elderly patients (aged 65 years or older), considering the individual psychological characteristics, such as personality and stress coping skills in response to anxiety, as confounding factors. Methods This prospective study included patients aged >65 years in a preoperative state before undergoing cardiovascular surgery. Subjects were divided into two groups based on whether they experienced postoperative delirium, or not. We compared clinical and demographic factors, preoperative psychiatric and psychological factors, and intraoperative and perioperative physical factors between the control and delirium groups. Multiple imputations were used to account for missing data. Results Out of 168 subjects enrolled in this study, 26 (15.5%) developed postoperative delirium. Univariate analysis showed significant differences in age (P = 0.027), cognitive function (P = 0.007), agreeableness (P = 0.029), and the Acute Physiology and Chronic Health Evaluation‐II (APACHE‐II) score (P = 0.023) between the delirium and control groups. Multiple logistic regression analysis did not identify a significant association between preoperative anxiety and the onset of postoperative delirium. However, age (odds ratio (OR) = 1.114, P = 0.018), agreeableness (OR = 0.555, P = 0.008), and the APACHE‐II score (OR = 1.227, P = 0.008) were identified as risk factors for postoperative delirium. Conclusion Agreeableness, one of the personality traits associated with preoperative anxiety, appears to be involved in the development of postoperative delirium as an independent psychological factor, regardless of age or physical factors.

show abstract

“…Patients undergoing cardiac surgery often perceive anxiety preoperatively, which is associated with postoperative delirium [ 9 ]. Known as the stress coping theory, understanding the meaning and importance of a particular stressor could facilitate stress coping and alleviate any anxiety [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

The impact of a preoperative nurse-led orientation program on postoperative delirium after cardiovascular surgery: a retrospective single-center observational study

et al. 2023

View full text Add to dashboard Cite

Background Postoperative delirium in intensive care is common and associated with mortality, cognitive impairment, prolonged hospital stays and high costs. We evaluate whether a nurse-led orientation program could reduce the incidence of delirium in the intensive care unit after cardiovascular surgery. Methods In this retrospective cohort study, we enrolled patients admitted to the intensive care unit for planned cardiovascular surgery between January 2020 and December 2021. A nurse-led orientation program based on a preoperative visit was routinely introduced from January 2021. We assessed the association between these visits and postoperative delirium in the intensive care unit. We also assessed predictors of postoperative delirium with baseline and intraoperative characteristics. Results Among 253 patients with planned cardiovascular surgery, 128 (50.6%) received preoperative visits. Valve surgery comprised 44.7%, coronary surgery 31.6%, and aortic surgery 20.9%. Cardiopulmonary bypass use and transcatheter surgery were 60.5% and 12.3%, respectively. Incidence of delirium was lower in patients that received preoperative visits, and median hospital stay was shorter than in those without visits (18 patients [14.1%] vs 34 patients [27.2%], P < 0.01; 14 days vs 17 days, P < 0.01). After adjusting predefined confounders, preoperative visits were independently associated with decreased incidence of delirium (adjusted odds ratio [aOR] 0.45; 95% confidence interval [95% CI] 0.22–0.84). Other predictors of delirium were higher European System for Cardiac Operative Risk Evaluation II score and lower minimum intraoperative cerebral oxygen saturation. Conclusions A preoperative nurse-led orientation program was associated with reduction of postoperative delirium and could be effective against postoperative delirium after cardiovascular surgery. Trial registration UMIN Clinical Trial Registry no. UMIN000048142. Registered 22, July, 2022, retrospectively registered, https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000054862.

show abstract

Preoperative Anxiety and Depression Increases the Incidence of Delirium After Coronary Artery Bypass Graft Surgery

Cited by 12 publications

References 32 publications

Cigarette smoking is linked to an increased risk of delirium following arthroplasty in patients suffering from osteoarthritic pain

Cigarette smoking is linked to an increased risk of delirium following arthroplasty in patients suffering from osteoarthritic pain

Relationship between preoperative anxiety and onset of delirium after cardiovascular surgery in elderly patients: focus on personality and coping process

The impact of a preoperative nurse-led orientation program on postoperative delirium after cardiovascular surgery: a retrospective single-center observational study

Contact Info

Product

Resources

About