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Observational Study
. 2024 Aug 1;19(1):476.
doi: 10.1186/s13019-024-02958-7.

Association of postoperative delirium with hypotension in critically ill patients after cardiac surgery: a prospective observational study

Saleh Mohammed Alhaj Othman  1 , Mohammed Ali Ali Aziz  1 , Gaber Musaed Ali Al-Mushiki  1 , Chanyanud Sriwayyapram  1 , Tecleab Okubai  1 , Gamil Al-Muwaffaq  1 , Qin Xu  2 , Mohammed Alqudaimi  1
Affiliations
Observational Study

Association of postoperative delirium with hypotension in critically ill patients after cardiac surgery: a prospective observational study

Saleh Mohammed Alhaj Othman et al. J Cardiothorac Surg. .

Abstract

Background: Postoperative delirium (POD), an acute and variable disturbance in cognitive function, is an intricate and elusive phenomenon that occurs after cardiac surgery. Despite progress in surgical techniques and perioperative management, POD remains a formidable challenge, imposing a significant burden on patients, caregivers, and healthcare systems.

Methods: This prospective observational study involved 307 patients who underwent cardiac surgery. Data on the occurrence of delirium, clinical parameters, and postoperative characteristics were collected. A multivariate analysis was performed to assess the relationship between POH and POD.

Results: Sixty-one patients (21%) developed delirium, with an average onset of approximately 5 days postoperatively and a duration of approximately 6 days. On multivariate analysis, POH was significantly associated with POD, and the adjusted odds ratios indicated that patients with POH were more likely to develop delirium (OR, 5.61; p = 0.006). Advanced age (OR, 1.11; p = 0.002), emergency surgery (OR, 8.31; p = 0.001), and on-pump coronary artery bypass grafting were identified as risk factors of POD. Patients who developed delirium were typically older, more likely to be male, and had higher morbidity rates than those who did not.

Conclusion: POH is significantly associated with delirium in critically ill patients after cardiac surgery. Surgical complexity and advanced age contribute to the risk of developing POD and poor postoperative outcomes.

Keywords: Adult population; Critical illness; Delirium; Open heart surgery; Postoperative care; Postoperative hypotension; Surgery-related complications.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Patient flow diagram. Abbreviations: ICU, intensive care unit; IOH, intraoperative hypotension
Fig. 2
Fig. 2
Forest plot showing the odds ratios (OR) and 95% confidence intervals (CI) for various factors associated with postoperative delirium. Significant associations were found with age (OR 1.11, 95% CI 1.04-1.19, p = 0.002), morbidity (OR 2.84, 95% CI 1.13-7.1, p = 0.026), hypotension (OR 5.61, 95% CI 1.65-19.11, p = 0.006), and emergency surgery (OR 8.31, 95% CI 3.25-21.3, p = 0.001)
See this image and copyright information in PMC

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