Background and aim: Several risk factors could contribute to the development of delirium, such as the use of some sedative drugs and a patient’s history with certain types of acute chronic disease. However, in the literature, there is little knowledge about the association between delirium in patients who have undergone cardio-surgical intervention and their clinical and environmental predictors. This study observe the clinical and structural factors that can be associated with the post-operative onset of delirium in patients who have undergone heart surgery. Methods: We used an observational design. We enrolled 89 hospitalised patients in the ICU. Patients were first evaluated using the Richmond Agitation Sedation Scale (RASS) and subsequently using the Confusion Assessment Method for the ICU (CAM-ICU). A linear model of regression was used to identify the predictors of delirium in patients. Results: The patients had an average age of 89 years (SD=6.9), were predominantly male (84.3%) and were mostly married (79.8%). The majority of patients had been subjected to bypass (80.9%), while 19.1% had undergone the intervention of endo prosthesis. The logistic regression model showed that patient age, the duration of VAM, continuous exposure to artificial light and the presence of sleep disorders were predictors of the onset of delirium. Conclusion: This study further confirms that clinical aspects such as insomnia and one’s circadian rhythm as well as structural elements such as exposure to artificial light are variables that should be monitored in order to prevent and treat the onset of severe post-operative delirium.

ICU Cardiochirurgica: quali sono i fattori di sviluppo del delirium? Studio osservazionale

SIMEONE S;
2018

Abstract

Background and aim: Several risk factors could contribute to the development of delirium, such as the use of some sedative drugs and a patient’s history with certain types of acute chronic disease. However, in the literature, there is little knowledge about the association between delirium in patients who have undergone cardio-surgical intervention and their clinical and environmental predictors. This study observe the clinical and structural factors that can be associated with the post-operative onset of delirium in patients who have undergone heart surgery. Methods: We used an observational design. We enrolled 89 hospitalised patients in the ICU. Patients were first evaluated using the Richmond Agitation Sedation Scale (RASS) and subsequently using the Confusion Assessment Method for the ICU (CAM-ICU). A linear model of regression was used to identify the predictors of delirium in patients. Results: The patients had an average age of 89 years (SD=6.9), were predominantly male (84.3%) and were mostly married (79.8%). The majority of patients had been subjected to bypass (80.9%), while 19.1% had undergone the intervention of endo prosthesis. The logistic regression model showed that patient age, the duration of VAM, continuous exposure to artificial light and the presence of sleep disorders were predictors of the onset of delirium. Conclusion: This study further confirms that clinical aspects such as insomnia and one’s circadian rhythm as well as structural elements such as exposure to artificial light are variables that should be monitored in order to prevent and treat the onset of severe post-operative delirium.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11591/458427
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