Forschung & Innovation
Publikationen
Impact of delirium in cardiosurgical patients on short- and long-term mortality
PMU Autor*in
Peter Nydahl
Alle Autor*innen
Baland Mohammad, Peter Nydahl, Hanna Gravert, Christina Grothusen, Katharina Huenges, Christine Friedrich, Wiebke Sommer, Assad Haneya, Gregor Warnecke, Bernd Panholzer
Fachzeitschrift
INTENSIVE AND CRITICAL CARE NURSING
Kurzfassung
Background Postoperative delirium (POD) is a common and serious complication in intensive care unit (ICU) patients after cardiac surgery. Its long-term impact remains uncertain. The aim was to determine the association between postoperative delirium and 8-year all-cause mortality in adult cardiac ICU patients. Methods This retrospective cohort study analysed patients admitted to a university hospital ICU following cardiac surgery. Data from pre-, peri-, and postoperative phases were collected. The primary outcome was mortality up to 8 years after ICU discharge. Secondary outcomes included POD incidence, ICU readmission, mortality at day 7 and 30 post-discharge, and ICU and hospital length of stay (LoS). Regression analyses were conducted to examine associations. Results The study included 551 patients, predominantly male (71 %, n = 397), with a median age of 72 (IQR 64-77) years. POD was diagnosed in 18.7 % (n = 103). Overall, the 8-year mortality rate was 16.7 % (n = 92). Compared to non-POD patients, those with POD had significantly higher 6-8 years mortality (n = 9 (8.7 %) vs. n = 16 (3.6 %), p = 0.033). Patients with POD had a longer LoS in ICU (median 4 vs. 2 days, p < 0.001) and hospital (15 vs. 12 days, p < 0.001), as well as higher ICU readmission rates within 30 days (12.3 % vs. 6.6 %, p = 0.037). POD patients also showed higher mortality at 30 days (3.8 % vs. 0.9 %, p = 0.028). However, after adjusting for confounders, POD was no longer significantly associated with long-term 6-8 years mortality (p = 0.205). Conclusions POD affects nearly one in five patients after cardiac surgery and is associated with adverse short-term outcomes, including longer stays and higher readmission and early mortality rates. Its independent effect on long-term mortality may be limited. Further studies are needed to explore its influence on quality of life and cognitive function.
Keywords
MORTALITY, COPD, ENCEPHALOPATHY, DELIRIUM, Cardiac surgery, Clonidine, Haloperidol, Intensive Care Medicine, Long-term outcome