title: Detection, Prevention, and Management of Delirium in the Critically Ill Cardiac Patient and Patients Who Undergo Cardiac Procedures.
abstract: Delirium is an acute change in cognitive functioning, characterized by inattention and associated with alterations in awareness and fluctuation in arousal, disorganized thinking, or altered level that preferentially affects older adult patients. In the acutely ill cardiac patient, the incidence of delirium has been reported as high as 73%, depending on the type and sensitivity of delirium assessment. Cardiac patients with delirium experience higher rates of in-hospital and longer-term mortality and are at risk for progressive cognitive impairment, loss of functional independence, and increased hospitalization costs. As such, delirium represents an undesirable outcome in cardiac patients. Care improvements such as identifying risk of delirium at time of admission or in the preoperative setting; training cardiologist, surgeons, anaesthesiologists and nurses to screen for delirium; implementing delirium prevention programs; and developing standardized delirium treatment protocols might reduce the incidence of delirium and its associated morbidity.
authors.affiliation: Department of Surgery, College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Cardiac Sciences Program, St Boniface Hospital, Winnipeg, Manitoba, Canada. Electronic address: rakeshcarora@gmail.com.
authors.forename: Rakesh C
authors.initials: RC
authors.lastname: Arora
authors.affiliation: Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: George
authors.initials: G
authors.lastname: Djaiani
authors.affiliation: Center of Innovation in Long Term Services and Supports, Providence VA Medical Center; Center for Gerontology, Brown School of Public Health; and Department of Medicine, Alpert Medical School of Brown University, Providence, Rhode Island, USA.
authors.forename: James L
authors.initials: JL
authors.lastname: Rudolph
mesh_terms: D006348:Cardiac Surgical Procedures; D016638:Critical Illness; D003693:Delirium / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D006331:Heart Diseases / Q000150:complications* / Q000601:surgery; D006801:Humans; D011300:Preoperative Care / Q000379:methods*