The Association of Infection with Delirium in the Post-Operative Period after Elective CABG Surgery

Żukowska, Agnieszka; Kaczmarczyk, Mariusz; Listewnik, Mariusz; Żukowski, Maciej

doi:10.3390/jcm12144736

JCM

2023

DOI: 10.3390/jcm12144736

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The Association of Infection with Delirium in the Post-Operative Period after Elective CABG Surgery

Agnieszka Żukowska¹,

Mariusz Kaczmarczyk

Mariusz Listewnik

et al.

Abstract: Delirium is one of the most common complications of coronary artery by-pass graft (CABG) surgery. The identification of patients at increased risk of delirium and the implementation of preventive measures to reduce the risk of postoperative delirium is necessary to improve treatment outcomes after CABG. The aim of this study was to assess the association between postoperative delirium and postoperative infection and 10-year mortality in patients undergoing CABG surgery. This is a retrospective, observational c… Show more

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Cited by 3 publications

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Risk factors for pulmonary complications after colorectal cancer surgery: a Japanese multicenter study

Tominaga,

Nonaka,

Takamura

et al. 2024

Int J Colorectal Dis

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Purpose Pulmonary complications (PC) are a serious condition with a 20% mortality rate. However, few reports have examined risk factors for PC after colorectal surgery. This study investigated the frequency, characteristics, and risk factors for PC after colorectal cancer surgery. Methods Between January 2016 and December 2022, we retrospectively reviewed 3979 consecutive patients who underwent colorectal cancer surgery in seven participating hospitals. Patients were divided into patients who experienced PC (PC group, n = 54) and patients who did not (non-PC group, n = 3925). Clinical and pathological features were compared between groups. Results Fifty-four patients (1.5%) developed PC, of whom 2 patients (3.7%) died due to PC. Age was greater (80 years vs 71 years; p < 0.001), frequency of chronic obstructive pulmonary distress was greater (9.3% vs 3.2%; p = 0.029), performance status was poorer (p < 0.001), the proportion of underweight was higher (42.6% vs 13.4%, p < 0.001), frequency of open surgery was greater (24.1% vs 9.3%; p < 0.001), and blood loss was greater (40 mL vs 22 mL; p < 0.001) in the PC group. Multivariate analysis revealed male sex (odds ratio (OR) 2.165, 95% confidence interval (CI) 1.176–3.986; p = 0.013), greater age (OR 3.180, 95%CI 1.798–5.624; p < 0.001), underweight (OR 3.961, 95%CI 2.210–7.100; p < 0.001), and poorer ASA-PS (OR 3.828, 95%CI 2.144–6.834; p < 0.001) as independent predictors of PC. Conclusion Our study revealed male sex, greater age, underweight, and poorer ASA-PS as factors associated with development of PC, and suggested that pre- and postoperative rehabilitation and pneumonia control measures should be implemented for patients at high risk of PC.

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Risk factors for pulmonary complications after colorectal cancer surgery: a Japanese multicenter study

Tominaga,

Nonaka,

Takamura

et al. 2024

Int J Colorectal Dis

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Delirium care burden of intensive care nurses caring for patients undergoing open‐heart surgery: A mixed‐method research

Ulus,

Durmaz Edeer

2024

Nursing in Critical Care

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BackgroundDelirium is an acute confusional state characterized by inattention, cognitive dysfunction and an altered level of consciousness. Delirium causes negative outcomes in patients, and patients with delirium increase the workload of nurses. Therefore, it is important to recognize the challenges and burdens experienced by nurses caring for patients with delirium.AimTo determine the subjective burden experienced by intensive care nurses caring for patients who have undergone open‐heart surgery.Study DesignA mixed‐method sequential explanatory design. A non‐probability purposive sampling method was used for the quantitative stage. Using OpenEpi, we employed the method of sample calculation with an unknown universe. The sample size of the quantitive study comprised 130 nurses. Quantitative data were collected with Google survey. For gathering qualitative data, online video interviews were conducted with 10 nurses, an interpretive phenomenological approach was used and content analysis was performed.ResultsIn the quantitative phase, we found that the subjective burden was high. In the qualitative phase, five main themes emerged: difficulty in recognizing delirium, physical burden, emotional burden, burden in care management of patients with delirium and the effect of patients with delirium on other patients. The nurses experienced physical and emotional burden in delirium management and felt lonely while caring for patients with delirium.ConclusionsBecause nurses play a key role in the care of patients with delirium, reducing the burden nurses experience when caring for patients with delirium should be considered important in ensuring that this patient population receives adequate care.Relevance to Clinical PracticeDelirium patients create a care burden for intensive care nurses. To reduce this burden of care, in‐service training in patient management and bedside teaching support should be provided to nurses. Furthermore, the use of a valid scale to diagnose delirium should be integrated into health policies. Nurses should not be left alone in the management of delirium. Managing delirium patients with a team including physicians, nurses and professionals from other health disciplines will ensure that patients receive high‐quality care, thereby reducing the care burden of nurses.

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Association of postoperative delirium with hypotension in critically ill patients after cardiac surgery: a prospective observational study

Othman,

Aziz,

Al-Mushiki

et al. 2024

J Cardiothorac Surg

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Background Postoperative delirium (POD), an acute and variable disturbance in cognitive function, is an intricate and elusive phenomenon that occurs after cardiac surgery. Despite progress in surgical techniques and perioperative management, POD remains a formidable challenge, imposing a significant burden on patients, caregivers, and healthcare systems. Methods This prospective observational study involved 307 patients who underwent cardiac surgery. Data on the occurrence of delirium, clinical parameters, and postoperative characteristics were collected. A multivariate analysis was performed to assess the relationship between POH and POD. Results Sixty-one patients (21%) developed delirium, with an average onset of approximately 5 days postoperatively and a duration of approximately 6 days. On multivariate analysis, POH was significantly associated with POD, and the adjusted odds ratios indicated that patients with POH were more likely to develop delirium (OR, 5.61; p = 0.006). Advanced age (OR, 1.11; p = 0.002), emergency surgery (OR, 8.31; p = 0.001), and on-pump coronary artery bypass grafting were identified as risk factors of POD. Patients who developed delirium were typically older, more likely to be male, and had higher morbidity rates than those who did not. Conclusion POH is significantly associated with delirium in critically ill patients after cardiac surgery. Surgical complexity and advanced age contribute to the risk of developing POD and poor postoperative outcomes.

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The Association of Infection with Delirium in the Post-Operative Period after Elective CABG Surgery

Cited by 3 publications

References 31 publications

Risk factors for pulmonary complications after colorectal cancer surgery: a Japanese multicenter study

Risk factors for pulmonary complications after colorectal cancer surgery: a Japanese multicenter study

Delirium care burden of intensive care nurses caring for patients undergoing open‐heart surgery: A mixed‐method research

Association of postoperative delirium with hypotension in critically ill patients after cardiac surgery: a prospective observational study

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