The incidence and consequences of mental disturbances in elderly patients post cardiac surgery--a comparison with younger patients.
BACKGROUND
Limited data exist about the incidence and consequences of mental confusion following open heart surgery in different age groups. Likewise, little is known about preoperative predictors of mental confusion.


METHODS
Two-hundred consecutive patients, aged > or =75 years (Group 1), and 400 procedure- and gender-matched younger patients (Group 2) who underwent coronary or valvular surgery were included in a prospective study. The relation between postoperative mental confusion, mortality, morbidity, and quality of life was studied.


RESULTS
Mental confusion was present in 11.8% Group 2 and 22.6% Group 1 patients. The incidence was higher after valvular surgery. Preoperative risk factors in Group 1 patients were diabetes mellitus, a history of heart failure, weak carotid pulsations, and repeat surgery. Late mortality, after a median follow-up duration of 31 months, was significantly worse in patients who were confused, which was related to the underlying disease. Recovery of quality of life was clearly diminished in elderly patients with confusion in contrast to younger patients.


CONCLUSIONS
Postoperative mental confusion has a high incidence in the elderly population and is associated with a diminished quality of life.
Heijmeriks
J A
JA
Department of Cardiology, Academic Hospital, Maastricht, The Netherlands.
Dassen
W
W
Prenger
K
K
Wellens
H J
HJ
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D006331:Heart Diseases / Q000401:mortality / Q000601:surgery*; D006801:Humans; D015994:Incidence; D001523:Mental Disorders / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D012307:Risk Factors; D015996:Survival Rate