Review
Cardiac & Cardiovascular Systems
Lingyu Lin, Xuecui Zhang, Shurong Xu, Yanchun Peng, Sailan Li, Xizhen Huang, Liangwan Chen, Yanjuan Lin
Summary: This study conducted a systematic review and meta-analysis to evaluate the correlation between postoperative delirium (POD) and outcomes in patients undergoing cardiac surgery. The findings showed that POD is associated with higher mortality, longer ICU and hospital stays, and a longer duration of mechanical ventilation. This research highlights the importance of understanding and intervening in POD.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Anesthesiology
Peng Li, Lu-xi Li, Zhen-zhen Zhao, Jian Xie, Cheng-long Zhu, Xiao-ming Deng, Jia-feng Wang
Summary: In this study, dexmedetomidine was found to reduce the incidence of POD after cardiac surgery. It is effective in adult cardiac surgery patients when used after surgery.
BMC ANESTHESIOLOGY
(2021)
Review
Anesthesiology
Abiodun M. Noah, Dalal Almghairbi, Rachel Evley, Iain K. Moppett
Summary: The higher preoperative levels of interleukin-6 and neopterin are associated with postoperative delirium in older adults. The association between preoperative blood levels of inflammatory mediators and postoperative delirium may be influenced by the type of surgery and the specific mediator. Further studies need to consider the potential modulating effects of surgery type, intrinsic brain vulnerability, and complex interactions between inflammatory mediators and binding proteins.
BRITISH JOURNAL OF ANAESTHESIA
(2021)
Review
Pharmacology & Pharmacy
Wenxue Liu, Yali Wang, Junxia Wang, Jian Shi, Jun Pan, Dongjin Wang
Summary: Glucocorticoids did not significantly reduce the incidence of postoperative delirium after cardiac surgery, but increased the risk of myocardial injury and decreased the duration of mechanical ventilatory support.
CLINICAL THERAPEUTICS
(2021)
Article
Anesthesiology
Selena Gong, Dorothy Qian, Sheila Riazi, Frances Chung, Marina Englesakis, Qixuan Li, Ella Huszti, Jean Wong
Summary: This systematic review and meta-analysis examined the association between the FRAIL scale and mortality and postoperative outcomes in older surgical patients. The results showed that frailty was associated with 30-day mortality, 6-month mortality, postoperative complications, and postoperative delirium.
ANESTHESIA AND ANALGESIA
(2023)
Review
Medicine, General & Internal
Kuo-Chuan Hung, Chong-Chi Chiu, Chih-Wei Hsu, Chun-Ning Ho, Ching-Chung Ko, I-Wen Chen, Cheuk-Kwan Sun
Summary: This study aims to assess the association between prognostic nutritional index (PNI) and the risk of postoperative delirium (POD) in adult patients. The results showed a negative association between PNI and POD, suggesting the need for further large-scale studies for validation.
FRONTIERS IN MEDICINE
(2023)
Article
Psychiatry
Dong Yun Lee, Ah Ran Oh, Jungchan Park, Seung-Hwa Lee, Byungjin Choi, Kwangmo Yang, Ha Yeon Kim, Rae Woong Park
Summary: This study aimed to establish a prediction model for delirium using machine learning algorithms. The top five variables selected for the model were age, operation duration, physical status classification, male sex, and surgical risk. The model demonstrated a sensitivity of 0.76 and a specificity of 0.84 in predicting delirium occurrence.
Review
Anesthesiology
Lina Chen, Emily Au, Aparna Saripella, Paras Kapoor, Ellene Yan, Jean Wong, David F. Tang-Wai, David Gold, Sheila Riazi, Colin Suen, David He, Marina Englesakis, Mahesh Nagappa, Frances Chung
Summary: This study aimed to investigate the impact of cognitive impairment and dementia on adverse outcomes in older surgical patients. The findings showed that preoperative cognitive impairment significantly increased the risk of delirium, mortality, discharge to assisted care, 30-day readmissions, and postoperative complications. Dementia was also found to increase the risk of 1-year mortality.
JOURNAL OF CLINICAL ANESTHESIA
(2022)
Review
Anesthesiology
Massimo Meco, Enrico Giustiniano, Maurizio Cecconi, Giovanni Albano
Summary: The incidence of postoperative delirium in patients undergoing cardiac surgery is high and can lead to increased morbidity and mortality. There is currently no clear evidence that any drug can prevent postoperative delirium in these patients. This Bayesian network meta-analysis aimed to assess if any drug is effective in reducing the incidence of postoperative delirium in cardiac surgical patients. The analysis showed that preoperative subanesthetic doses of ketamine significantly reduce the incidence of postoperative delirium. Risperidone also decreases the incidence, but not significantly.
JOURNAL OF ANESTHESIA
(2023)
Article
Psychology, Clinical
Sophia Wang, Ryan Greene, Yiqing Song, Carol Chan, Heidi Lindroth, Sikandar Khan, Gabriel Rios, Robert D. Sanders, Babar Khan
Summary: This study used meta-analysis to identify biomarkers of Alzheimer's and related dementias (ADRD) associated with postoperative delirium (POD). Certain inflammatory and neuronal injury biomarkers were found to be significantly related to POD. Future studies should further investigate these relationships and incorporate amyloid and tau biomarkers to better understand the relationship between POD and ADRD.
INTERNATIONAL PSYCHOGERIATRICS
(2022)
Article
Cardiac & Cardiovascular Systems
Hongbai Wang, Xiaoxiao Guo, Xianlin Zhu, Yinan Li, Yuan Jia, Zhe Zhang, Su Yuan, Fuxia Yan
Summary: This retrospective case-control study found that male gender is a significant risk factor for postoperative delirium (POD) in patients following cardiac valve surgery, especially in patients aged younger than 60 years. The study also showed that the incidence of hyperactive delirium is higher in males, emphasizing the importance of attention to male patients to prevent POD occurrence.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2021)
Review
Anesthesiology
Ellene Yan, Matthew Veitch, Aparna Saripella, Yasmin Alhamdah, Nina Butris, David F. Tang-Wai, Maria Carmela Tartaglia, Mahesh Nagappa, Marina Englesakis, David He, Frances Chung
Summary: This study aimed to evaluate the incidence and outcomes of postoperative delirium in older non-cardiac surgical patients. The pooled incidence of postoperative delirium was 19% after elective surgery and 32% after emergency surgery. Postoperative delirium was associated with increased mortality, complications, unplanned intensive care unit admissions, prolonged hospital stay, and non-home discharge.
JOURNAL OF CLINICAL ANESTHESIA
(2023)
Article
Cardiac & Cardiovascular Systems
Yue Chang, Sandra M. Ragheb, Nebojsa Oravec, David Kent, Kristina Nugent, Alexandra Cornick, Brett Hiebert, James L. Rudolph, Alasdair M. J. MacLullich, Rakesh C. Arora
Summary: This study validated the 4 A's Test delirium screening tool and evaluated its accuracy when used by research assistants and subsequently implemented by nursing staff. The results showed that the 4 A's Test had moderate sensitivity and high specificity for detecting delirium among cardiac surgery patients on the postoperative ward.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2023)
Review
Cardiac & Cardiovascular Systems
Yi Pang, Yuntao Li, Yonggang Zhang, Hongfa Wang, Junhui Lang, Liang Han, He Liu, Xiaoxing Xiong, Lijuan Gu, Xiaomin Wu
Summary: The past decade has seen significant progress in medical field, making cardiac surgery more common and safer. However, postoperative delirium remains a major concern, with research focusing on potential triggers like inflammation and oxidative stress, as well as perioperative risk factors and interventions.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Review
Cardiac & Cardiovascular Systems
Li-Juan Tian, Su Yuan, Cheng-Hui Zhou, Fu-Xia Yan
Summary: This study found that intraoperative cerebral oximetry monitoring-guided intervention is associated with a reduced risk of postoperative delirium and cognitive decline, as well as a shorter ICU stay in adult cardiac surgery patients.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)