Intraoperative hypotension and delirium after on-pump cardiac surgery

Delirium is a common complication after cardiac surgery and may be as a result of inadequate cerebral perfusion. We studied delirium after cardiac surgery in relation to intraoperative hypotension (IOH). This observational single-centre, cohort study was nested in a randomized trial, on a single int...

Full description

Saved in:
Bibliographic Details
Published in:British journal of anaesthesia : BJA 2015-09, Vol.115 (3), p.427-433
Main Authors: Wesselink, E.M., Kappen, T.H., van Klei, W.A., Dieleman, J.M., van Dijk, D., Slooter, A.J.C.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Antiemetics - administration & dosage
Cardiac Surgical Procedures
Clinical Practice
Cohort Studies
Delirium - epidemiology
delirium dementia, amnestic cognitive disorders
Dexamethasone - administration & dosage
Female
Humans
hypotension
Hypotension - epidemiology
Intraoperative Complications - epidemiology
Male
Middle Aged
Postoperative Complications - epidemiology
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Delirium is a common complication after cardiac surgery and may be as a result of inadequate cerebral perfusion. We studied delirium after cardiac surgery in relation to intraoperative hypotension (IOH). This observational single-centre, cohort study was nested in a randomized trial, on a single intraoperative dose of dexamethasone vs placebo during cardiac surgery. During the first four postoperative days, patients were screened for delirium based on the Confusion Assessment Method (CAM) for Intensive Care Unit on the intensive care unit, CAM on the ward, and by inspection of medical records. To combine depth and duration of IOH, we computed the area under the curve for four blood pressure thresholds. Logistic regression analyses were performed to investigate the association between IOH and the occurrence of postoperative delirium, adjusting for confounding and using a 99% confidence interval to correct for multiple testing. Of the 734 included patients, 99 patients (13%) developed postoperative delirium. The adjusted Odds Ratio for the Mean Arterial Pressure
ISSN:0007-0912
1471-6771
DOI:10.1093/bja/aev256