The DISCERN (Discovering Innovative Strategies for prevention of delirium in Cardiac surgery patients through Evaluation of peri-operative Risk and Novel biomarkers) Study – Intermediate and long-term follow up of post-operative health-related quality of life and mental health status.
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Date
2015-08-08
Authors
Nguyen, Quyen
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Abstract
Delirium is an acute form of “brain failure” characterized by fluctuation of attention and
cognition. It is the most common neurological complication following cardiac surgery. The
incidence of post-operative delirium in surgical patients varies between 10-60%, but can be as
high as 73% in the elderly. Our study objectives were: 1) to examine the effect of post-operative
delirium on mid- to long-term health-related quality of life (HRQoL) in patients following cardiac
surgery, 2) to examine the effect of post-operative delirium on mental health following cardiac
surgery and 3) to determine risk factors for each of these conditions.
A prospective observational cohort study was carried out at a tertiary care centre in
Winnipeg, Manitoba. Within the study cohort of 197 patients, the rate of post-operative delirium
was 21.1% in elective cardiac surgery patients and 30.8% in urgent or emergent patient. Preoperative
predictors of post-operative delirium were higher EuroSCORE II, previous
cardiovascular procedure, older age, less than high school education and left ventricular
ejection fraction of <35%. Intra-operative predictors of post-operative delirium were increased
cardiopulmonary pump time, acute kidney injury, returning to the OR due to post-operative
bleeding and new cerebrovascular accident. Delirious patients remained in the ICU almost 4
times longer than non-delirious patients and were hospitalized on average 5 days longer.
Patients who suffered from post-operative delirium were 2 times more likely to score below
average in the physical health aspect of the SF-12v2 and were nearly 3 times more likely to
report having a problem with anxiety or depression.
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DISCERN