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Preoperative cardiac function parameters as valuable predictors for nurses to recognise delirium after cardiac surgery: A prospective cohort study.
- Source :
-
European Journal of Cardiovascular Nursing . Apr2020, Vol. 19 Issue 4, p310-319. 10p. - Publication Year :
- 2020
-
Abstract
- Background: Delirium is a common postoperative complication after cardiac surgery. The relationship between delirium and cardiac function has not been fully elucidated. Aims: The aim of this study was to identify the association between preoperative cardiac function and delirium among patients after cardiac surgery. Methods: We prospectively recruited 635 cardiac surgery patients with a planned cardiac intensive care unit admission. Postoperative delirium was diagnosed using the confusion assessment method for the intensive care unit. Preoperative cardiac function was assessed using N-terminal prohormone of brain natriuretic peptide (NT-proBNP), New York Heart Association functional classification and left ventricular ejection fraction. Results: Delirium developed in 73 patients (11.5%) during intensive care unit stay. NT-proBNP level (odds ratio (OR) 1.24, 95% confidence interval (CI) 1.01–1.52) and New York Heart Association functional classification (OR 2.34, 95% CI 1.27–4.31) were both independently associated with the occurrence of delirium after adjusting for various confounders. The OR of delirium increased with increasing NT-proBNP levels after the turning point of 7.8 (log-transformed pg/ml). The adjusted regression coefficients were 1.19 (95% CI 0.95–1.49, P =0.134) for NT-proBNP less than 7.8 (log-transformed pg/ml) and 2.78 (95% CI 1.09–7.12, P =0.033) for NT-proBNP greater than 7.8 (log-transformed pg/ml). No association was found between left ventricular ejection fraction and postoperative delirium. Conclusion: Preoperative cardiac function parameters including NT-proBNP and New York Heart Association functional classification can predict the incidence of delirium following cardiac surgery. We suggest incorporating an early determination of preoperative cardiac function as a readily available risk assessment for delirium prior to cardiac surgery. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ACADEMIC medical centers
*CARDIOVASCULAR disease nursing
*CARDIOVASCULAR system physiology
*CHI-squared test
*CONFIDENCE intervals
*CARDIAC surgery
*INTENSIVE care units
*LONGITUDINAL method
*MULTIVARIATE analysis
*PATIENTS
*PEPTIDE hormones
*POSTOPERATIVE period
*PSYCHOLOGICAL tests
*RESEARCH funding
*RISK assessment
*STATISTICAL sampling
*STATISTICS
*SURGERY
*LOGISTIC regression analysis
*PREOPERATIVE period
*DATA analysis software
*STATISTICAL models
*DESCRIPTIVE statistics
*ODDS ratio
*VENTRICULAR ejection fraction
RISK of delirium
SURGICAL complication risk factors
Subjects
Details
- Language :
- English
- ISSN :
- 14745151
- Volume :
- 19
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- European Journal of Cardiovascular Nursing
- Publication Type :
- Academic Journal
- Accession number :
- 142652579
- Full Text :
- https://doi.org/10.1177/1474515119886155