title: White-matter hyperintensities predict delirium after cardiac surgery.
abstract: OBJECTIVE
  Postoperative delirium is a common psychiatric disorder among patients who undergo cardiac surgery. Although several studies have investigated risk factors for delirium after cardiac surgery, the association between delirium and cerebral white-matter hyperintensities (WMH) on magnetic resonance (MR) imaging has not been previously studied. The aim of this study was to identify general risk factors for delirium, as well as to examine the specific relationship between WMH and delirium.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  A total of 130 patients who underwent cardiac surgery.
  
  
  METHODS
  Variables recorded included patient demographics, comorbidities, mental health, laboratory data, surgical information, and cerebrovascular disease. The presence of WMH was assessed using MR images. Two groups of patients were compared (patients with and without delirium) using both univariate and multiple logistic analyses.
  
  
  RESULTS
  Delirium occurred in 18 patients (13.8%) and patients with delirium were significantly older than patients who did not develop delirium. The prevalence of severe WMH (Fazekas score = 3) was significantly higher in patients with delirium. Three independent predictors of delirium were identified: abnormal creatinine (odds ratio [OR]: 4.5; 95% confidence interval [CI]: 1.4-13.9), severe WMH (OR: 3.9; 95% CI: 1.2-12.5), and duration of surgery (OR: 1.4; 95% CI: 1.0-1.8).
  
  
  CONCLUSIONS
  The results of this study suggest that white-matter abnormality is one of the most important risk factors for development of delirium after cardiac surgery. These factors can be used for prediction and prevention of delirium following cardiac surgery.
authors.affiliation: Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. Electronic address: yhatano@koto.kpu-m.ac.jp.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hatano
authors.forename: Jin
authors.initials: J
authors.lastname: Narumoto
authors.forename: Keisuke
authors.initials: K
authors.lastname: Shibata
authors.forename: Teruyuki
authors.initials: T
authors.lastname: Matsuoka
authors.forename: Shogo
authors.initials: S
authors.lastname: Taniguchi
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Hata
authors.forename: Kei
authors.initials: K
authors.lastname: Yamada
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yaku
authors.forename: Kenji
authors.initials: K
authors.lastname: Fukui
mesh_terms: D000368:Aged; D000375:Aging / Q000473:pathology / Q000523:psychology; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D016022:Case-Control Studies; D003693:Delirium / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D059906:Neuroimaging; D011183:Postoperative Complications / Q000175:diagnosis / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Cardiac surgery; delirium; magnetic resonance imaging; white matter