Prevalensi dan Faktor Risiko Delirium Pascaoperasi di Unit Perawatan Intensif Jantung (Abstrak Penelitian)

Prevalence and Risk Factors for Postoperative Delirium in a Cardiovascular Intensive Care Unit

By: Yu-Ling Chang, Yun-Fang Tsai, Pyng-Jing Lin, Min-Chi Chen and Chia-Yih Liu


Background Delirium after cardiac surgery is a common com¬plication in cardiovascular intensive care units. The prevalence of delirium and its likely risk factors have not previously been explored in a single sample of postoperative cardiac patients in an intensive care unit.

Objective To compare a variety of characteristics in patients with and without delirium and to identify risk factors associ¬ated with delirium in patients hospitalized in an intensive care unit after cardiac surgery.

Methods A retrospective chart review was used to collect data on 288 patients who had open heart surgery during the period 2004 to 2005 at Chang Gung Memorial Hospital in northern Taiwan. A researcher-designed checklist of 52 patient-related risk factors for delirium was used to collect preoperative, intra¬operative, and postoperative data. All patients were assessed by psychiatrists, and delirium was diagnosed according to cri¬teria of the Diagnostic and Statistical Manual of Mental Disor¬ders, fourth edition. Data were analyzed via univariate analysis and multivariate logistic regression.

Results The prevalence of postoperative delirium was 41.7%. Patients with and without delirium differed significantly on 29 variables. Four postoperative factors, hematocrit less than 30%, cardiogenic shock, hypoalbuminemia, and acute infection, were significant, independent predictors of postoperative delirium.

Conclusions The results of this study can be used to develop a revised checklist of 29 preoperative, intraoperative, and post¬operative risk factors for delirium, with special attention to the 4 predictive postoperative factors. Use of such a checklist may facilitate the ability to prevent or detect delirium early and pro¬vide suitable treatment.

Sumber: American Journal of Critical Care. 2008;17:567-575