Dave, Mudra2024-09-122024-09-122024-09-102024-09-10http://hdl.handle.net/1993/38581Background: As cardiac surgery patients continue to age and present with more complex health conditions, the occurrence of a challenging postoperative complication known as "delirium" is becoming increasingly common. Postoperative delirium (PoD) is a complex neuropsychological disorder characterized by symptoms such as inattention, drowsiness, and agitation, which has many long-term negative health impacts. A patient-associated risk factor of PoD is presumed to be a preoperative alcohol use disorder (AUD). Objective: The primary purpose was to determine whether preoperative alcohol use, measured using the Alcohol Use Disorders Identification Test - Concise (AUDIT-C), is predictive of incident PoD in cardiac surgical patients. The secondary objective was to determine the risk factors associated with PoD available in the Manitoba Access Cardiac Surgery (MACS) database. Hypothesis: Primary: Higher AUDIT-C scores are associated with the incidence of PoD in adults who underwent cardiac surgery. Secondary: risk factors identified from the MACS database are correlated with PoD in adults who underwent cardiac surgery. Methods: This was a single-centre, retrospective observational cohort study. AUDIT-C score and PoD (as diagnosed using the Confusion Assessment Method (CAM) – ICU in the intensive care unit or CAM on the postoperative ward) were collected for all elective patients undergoing cardiac surgery between March 2015 – September 2020. Results: The overall incidence of delirium in this study was 14.2%. There was an association between preoperative alcohol use measured by AUDIT-C and PoD (0.559 OR, 0.515-0.607 95% CI, p = < 0.001) before controlling for covariates. After controlling for age, procedure category, MoCA score, CFS, LVEF category, renal insufficiency, previous CVA/TIA, recreational drug use and CPB time, there was no significant association between alcohol use and PoD (0.376 OR, 0.070-2.011 95% CI, p = 0.253). Previously known risk factors, including age, frailty, MoCA scores, renal insufficiency, previous CVA/TIA and CPB time, were found to be significant. Conclusion: Preoperative alcohol use measured by AUDIT-C is not a reliable predictor of PoD in cardiac surgery patients. Future research should explore the role of comprehensive measures of alcohol use on PoD.engdeliriumalcohol usecardiac surgeryThe impact of preoperative alcohol use screening on postoperative delirium in cardiac surgery patients: a retrospective observational studymaster thesis