title: Prevalence of delirium in opium users after coronary artery bypass graft surgery.
abstract: BACKGROUND
  Postoperative cognitive dysfunction, especially delirium commonly occurs after cardiac surgery. Clinical evidences suggest an increase in delirium in opium abusers after Coronary Artery Bypass Graft (CABG) surgery. In this study, the prevalence of delirium in addict (opium user) and nonaddict patients after CABG were compared.
  
  
  METHODS
  In a cross-sectional study after obtaining institutional approval and informed consent, 325 patients candidate for elective CABG were included in the study. All patients with history of opium abuse met the criteria for opioid dependence using Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition definitions. Delirium after CABG was assessed in addict (opium user) and nonaddict patients up to a maximum of 5 days after surgery with the Intensive Care Delirium Screening Checklist.
  
  
  RESULTS
  A total of 325 patients were evaluated (208 without and 117 with a history of opium abuse). Postoperative delirium occurred within 72 h after surgery in 44.31% of all patients. There was a significant difference in the prevalence of postoperative delirium between the opium users (80.7%) and nonaddict patients (25%) in the intensive care unit (P < 0.001). Opium addiction was a risk factor for postoperative delirium after CABG Surgery.
  
  
  CONCLUSIONS
  Delirium after CABG surgery is more prevalent in opium users compared with nonaddict patients. Therefore, opium abuse is a possible risk factor for postoperative delirium in cardiac surgical patients.
authors.affiliation: Department of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Nastaran
authors.initials: N
authors.lastname: Eizadi-Mood
authors.affiliation: Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Omid
authors.initials: O
authors.lastname: Aghadavoudi
authors.affiliation: Tehran Institute of Psychiatry, Faculty of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Najarzadegan
authors.affiliation: Tehran Institute of Psychiatry, Faculty of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Masoud Mozhdehi
authors.initials: MM
authors.lastname: Fard
keywords: Addiction; cardiac surgery; delirium; intensive care unit; opium
references.citation: Gen Thorac Cardiovasc Surg. 2010 Sep;58(9):456-60
references.pmid: 20859724
references.citation: Am J Med. 1994 Sep;97(3):278-88
references.pmid: 8092177
references.citation: JAMA. 1994 Jan 12;271(2):134-9
references.pmid: 8264068
references.citation: J Gerontol A Biol Sci Med Sci. 2004 Aug;59(8):818-26
references.pmid: 15345732
references.citation: JAMA. 1996 Mar 20;275(11):852-7
references.pmid: 8596223
references.citation: Intensive Care Med. 2001 May;27(5):859-64
references.pmid: 11430542
references.citation: Exp Toxicol Pathol. 2009 Mar;61(2):145-9
references.pmid: 18838257
references.citation: Cardiol J. 2010;17(3):254-8
references.pmid: 20535715
references.citation: J Am Geriatr Soc. 2005 Mar;53(3):462-6
references.pmid: 15743290
references.citation: Int J Nurs Stud. 2004 Jan;41(1):29-41
references.pmid: 14670392
references.citation: Arch Neurol. 2002 Sep;59(9):1422-8
references.pmid: 12223028
references.citation: Int J Soc Psychiatry. 1980;26(3):196-9
references.pmid: 7203862
references.citation: Cesk Fysiol. 2004;53(4):159-66
references.pmid: 15704740
references.citation: Arch Intern Med. 1995 Mar 13;155(5):461-5
references.pmid: 7864702
references.citation: Gan To Kagaku Ryoho. 2009 Oct;36(10):1683-9
references.pmid: 19838028
references.citation: Intensive Care Med. 2004 Nov;30(11):2009-16
references.pmid: 15372146
references.citation: Eur J Cardiovasc Prev Rehabil. 2007 Oct;14(5):715-7
references.pmid: 17925633
references.citation: Gen Hosp Psychiatry. 1996 Nov;18(6):448-51
references.pmid: 8937914
references.citation: J Am Geriatr Soc. 2006 Jun;54(6):937-41
references.pmid: 16776789
references.citation: Gen Thorac Cardiovasc Surg. 2010 Feb;58(2):62-7
references.pmid: 20155341
references.citation: Intensive Care Med. 2001 Aug;27(8):1297-304
references.pmid: 11511942
references.citation: J Adv Nurs. 1998 Jan;27(1):59-67
references.pmid: 9515609
references.citation: Am J Psychiatry. 1989 Apr;146(4):452-8
references.pmid: 2929744
references.citation: J Am Geriatr Soc. 2003 Oct;51(10):1439-44
references.pmid: 14511165
references.citation: Med Clin North Am. 2001 Sep;85(5):1229-39
references.pmid: 11565496
references.citation: Anesth Analg. 1995 Jun;80(6):1223-32
references.pmid: 7762856
references.citation: Actas Luso Esp Neurol Psiquiatr Cienc Afines. 1995 Jul-Aug;23(4):200-16
references.pmid: 7484305
references.citation: J Gen Intern Med. 1998 Mar;13(3):204-12
references.pmid: 9541379
references.citation: Chest. 2003 Mar;123(3):897-922
references.pmid: 12628894