Outcomes associated with postoperative delirium after cardiac surgery.
BACKGROUND
Delirium after surgery is a common condition that leads to poor outcomes. Few studies have examined the effect of postoperative delirium on outcomes after cardiac surgery.


OBJECTIVE
To assess the relationship between delirium after cardiac surgery and the following outcomes: length of stay after surgery, prevalence of falls, discharge to a nursing facility, discharge to home with home health services, and use of inpatient physical therapy.


METHODS
Electronic medical records of 656 cardiac surgery patients were reviewed retrospectively.


RESULTS
Postoperative delirium occurred in 161 patients (24.5%). Patients with postoperative delirium had significantly longer stays (P < .001) and greater prevalence of falls (P < .001) than did patients without delirium. Patients with delirium also had a significantly greater likelihood for discharge to a nursing facility (P < .001) and need for home health services if discharged to home (P < .001) and a significantly higher need for inpatient physical therapy (P < .001). Compared with patients without postoperative delirium, patients who had this complication were more likely to have received zolpidem and benzodiazepines postoperatively and to have a history of arrhythmias, renal disease, and congestive heart failure.


CONCLUSIONS
Patients who have delirium after cardiac surgery have poorer outcomes than do similar patients without this complication. Development and implementation of an extensive care plan to address postoperative delirium is necessary for cardiac surgery patients who are at risk for or have delirium after the surgery.
Ralph F. Mangusan is a clinical research nurse and Sheri A. Denslow is a biostatistician, Research Institute, Mission Hospital, Asheville, North Carolina. Vallire Hooper is a manager, Nursing Research, Mission Health System, Asheville, North Carolina. Lucille Travis is a professor, School of Nursing, University of North Carolina at Charlotte, Charlotte, North Carolina. Ralph.mangusan@msj.org.
Ralph Francis
RF
Mangusan
Ralph F. Mangusan is a clinical research nurse and Sheri A. Denslow is a biostatistician, Research Institute, Mission Hospital, Asheville, North Carolina. Vallire Hooper is a manager, Nursing Research, Mission Health System, Asheville, North Carolina. Lucille Travis is a professor, School of Nursing, University of North Carolina at Charlotte, Charlotte, North Carolina.
Vallire
V
Hooper
Ralph F. Mangusan is a clinical research nurse and Sheri A. Denslow is a biostatistician, Research Institute, Mission Hospital, Asheville, North Carolina. Vallire Hooper is a manager, Nursing Research, Mission Health System, Asheville, North Carolina. Lucille Travis is a professor, School of Nursing, University of North Carolina at Charlotte, Charlotte, North Carolina.
Sheri A
SA
Denslow
Ralph F. Mangusan is a clinical research nurse and Sheri A. Denslow is a biostatistician, Research Institute, Mission Hospital, Asheville, North Carolina. Vallire Hooper is a manager, Nursing Research, Mission Health System, Asheville, North Carolina. Lucille Travis is a professor, School of Nursing, University of North Carolina at Charlotte, Charlotte, North Carolina.
Lucille
L
Travis
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000453:epidemiology; D001569:Benzodiazepines / Q000009:adverse effects; D016063:Blood Loss, Surgical; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000534:rehabilitation; D015897:Comorbidity; D003693:Delirium / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D064650:Home Health Nursing / Q000706:statistics & numerical data*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects; D007674:Kidney Diseases / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011725:Pyridines / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D012866:Skilled Nursing Facilities / Q000706:statistics & numerical data*; D000077334:Zolpidem
D006993:Hypnotics and Sedatives; D011725:Pyridines; D001569:Benzodiazepines; D000077334:Zolpidem