Delirium and cognitive disorders after cardiac operations: relationship to pre- and intraoperative quantitative electroencephalogram.
We examined the incidence of delirium and cognitive disorders after cardiac operations and the related risk factors. The value of pre- and intraoperative QEEG was determined. Using the Mini-Mental State Examination and the Saskatoon Delirium Checklist, 321 patients were tested during the immediate postoperative period. Forty-four patients (14%) showed delirium, 68 (23%) cognitive disorders and 26 (9%) both. Significant risk factors for the development of cognitive disorders were age > or = 70 yr, female gender, duration of cardiopulmonary bypass > or = 2.5 h and aorta-cross-clamping > 70 min. Risk factors for delirium were age > or = 70 yr, female gender and Hb < 5 mmol 1(-1) intraoperatively. The preoperative QEEG showed significant differences between the groups with and without a cognitive disorder, while the intraoperative QEEG showed significant differences between the groups with and without delirium. Different risk factors for delirium and cognitive disorders are a possible explanation for the controversies in the literature, where neuropsychologic complications were grouped together. A low intraoperative Hb is an important risk factor for the development of delirium and can be treated. The preoperative QEEG may have prognostic significance in the occurrence of cognitive disorders, while the intraoperative QEEG may have prognostic significance in the occurrence of delirium.
Hofsté
W J
WJ
Department of Anaesthesiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
Linssen
C A
CA
Boezeman
E H
EH
Hengeveld
J S
JS
Leusink
J A
JA
de-Boer
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D003072:Cognition Disorders / Q000175:diagnosis*; D003693:Delirium / Q000175:diagnosis; D004569:Electroencephalography; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012307:Risk Factors