Postoperative Delirium Clinical Trial
Official title:
Predictors for Postoperative Delirium After Cardiac Surgery in Adults: a One-year, Single Center, Observational Cohort Study
The Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5) describes delirium
as a "disturbance in attention (i.e., reduced ability to direct, focus, sustain, and shift
attention) and awareness (reduced orientation to the environment)". In addition, a
"disturbance in cognition (e.g., memory deficit, disorientation, language, visuospatial
ability, or perception)" occurs.
Postoperative delirium (POD) usually develops in connection with a surgical procedure within
the first five days after an intervention. Roughly 10-70% of all surgical patients above the
age of 65 years are affected.
POD places not only a burden to the patient and their families by increasing functional and
cognitive damages, and increasing mortality, it also has a high impact on the health care
resource utilization. A patient with POD often requires more intensive care, has a longer
length of hospital stay, more complications, and often requires long-term care after being
discharged from the hospital. All these aspects show the need for prevention of POD.
There are various preoperative risk factors that influence the development of POD. Broad
research has been done on this topic and shown that advanced age, cognitive impairment,
depression and other psychopathologic symptoms, intake of psychotropic substances, sensory
impairment like decrease in visual or auditory perception, impairment in daily life
activities, dehydration, malnutrition, metabolic dysfunctions, urinary catheters, severity of
disease and different comorbidities, such as chronic cardiac insufficiency, atrial
fibrillation, or previous history of stroke or infections may favor the occurrence of POD.
The incidence of POD is among the highest in cardiac surgery. The study was designed to
assess predictors for POD after cardiac surgery. Study hypothesis is that some patient
variables, scores and biomarkers are not only predictive of the incidence of POD but also of
the severity of delirium-associated symptoms and duration of POD after cardiac surgery.
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