Prediction of delirium after cardiac surgery and the use of a risk checklist.
BACKGROUND
Delirium is a temporary mental disorder, which occurs frequently among patients who undergo cardiac surgery. Delirium prediction and its associated prevention is essential. In a previous study, a risk checklist for delirium was developed.


AIMS
The present study validated this checklist in a new, larger study population, and also investigated new risk factors.


METHODS
Risk factors were obtained during the preoperative outpatient screening in 300 patients who underwent elective cardiac surgery. The Delirium Observation Screening scale was utilized pre- and postoperatively to assess delirium.


RESULTS AND CONCLUSION
The incidence of delirium was 17.3%. A higher Euroscore, but not a disturbance in electrolytes, was confirmed as a predictor of postoperative delirium. Based on this study, a new risk model was constructed with the following risk factors: a higher Euroscore, older age (≥70 years), cognitive impairment, number of comorbidities, history of delirium, alcohol use and type of surgery. When using a probability of delirium of 20%, as predicted by the model, the sensitivity was 80.8% and the specificity 82.2%. The area under the curve was 0.89. With the revised delirium risk checklist, including seven new risk factors, patients with an increased risk of developing delirium following cardiac surgery could be identified more accurately.
['Koster|Sandra|S|', 'Hensens|Ab G|AG|', 'Schuurmans|Marieke J|MJ|', 'van der Palen|Job|J|']
D000368:Aged D000369:Aged, 80 and over D006348:Cardiac Surgical Procedures D057189:Checklist D015331:Cohort Studies D003693:Delirium D003866:Depressive Disorder D017558:Elective Surgical Procedures D005260:Female D006331:Heart Diseases D006801:Humans D007389:Internal-External Control D008297:Male D008875:Middle Aged D011237:Predictive Value of Tests D012307:Risk Factors D013001:Somatoform Disorders D013315:Stress, Psychological
delirium cardiac surgery prevention Aging