Delirium in older cardiac surgery patients: directions for practice.

Delirium affects approximately 20% to 25% of patients undergoing cardiac surgery and is particularly common in older adults. This article reviews the etiology and risk factors for delirium associated with cardiac surgery in older adults. Delirium screening, prevention, and treatment strategies, including both pharmacological and nonpharmacological therapies, are presented. Interventions appropriate in both the intensive care unit and

[1]  K. Wernecke,et al.  Different assessment tools for intensive care unit delirium: Which score to use?* , 2010, Critical care medicine.

[2]  Jack Chen,et al.  Prevalence of Delirium with Dexmedetomidine Compared with Morphine Based Therapy after Cardiac Surgery: A Randomized Controlled Trial (DEXmedetomidine COmpared to Morphine-DEXCOM Study) , 2009, Anesthesiology.

[3]  M. Boustani,et al.  Pharmacological Management of Delirium in Hospitalized Adults – A Systematic Evidence Review , 2009, Journal of general internal medicine.

[4]  J. van der Palen,et al.  The long-term cognitive and functional outcomes of postoperative delirium after cardiac surgery. , 2009, The Annals of thoracic surgery.

[5]  L. Lipsitz,et al.  Derivation and Validation of a Preoperative Prediction Rule for Delirium After Cardiac Surgery , 2009, Circulation.

[6]  D. Meagher.  Motor subtypes of delirium: Past, present and future , 2009, International review of psychiatry.

[7]  N. Mitsakakis,et al.  Preoperative Use of Statins Is Associated with Reduced Early Delirium Rates after Cardiac Surgery , 2009, Anesthesiology.

[8]  G. Meyfroidt,et al.  Is Preoperative Anxiety and Depression Associated with Onset of Delirium After Cardiac Surgery in Older Patients? A Prospective Cohort Study , 2008, Journal of the American Geriatrics Society.

[9]  Y. Tsai,et al.  Prevalence and risk factors for postoperative delirium in a cardiovascular intensive care unit. , 2008, American journal of critical care : an official publication, American Association of Critical-Care Nurses.

[10]  M. Banach,et al.  The significance of preoperative atrial fibrillation in patients undergoing cardiac surgery: preoperative atrial fibrillation--still underestimated opponent. , 2008, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.

[11]  P. Trzepacz,et al.  Designing clinical trials for the treatment of delirium. , 2008, Journal of psychosomatic research.

[12]  Melinda R. Steis,et al.  Are nurses recognizing delirium? A systematic review. , 2008, Journal of gerontological nursing.

[13]  M. Kuskowski,et al.  Incidence and predictors of post-cardiotomy delirium. , 2008, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[14]  S. Inouye,et al.  The Confusion Assessment Method: A Systematic Review of Current Usage , 2008, Journal of the American Geriatrics Society.

[15]  H. Sintonen,et al.  Postoperative delirium and health related quality of life after coronary artery bypass grafting , 2008, Scandinavian cardiovascular journal : SCJ.

[16]  O. Cameron.  Delirium, depression, and other psychosocial and neurobehavioral issues in cardiovascular disease. , 2007, Critical care clinics.

[17]  E. Ely,et al.  The importance of diagnosing and managing ICU delirium. , 2007, Chest.

[18]  A. Berney,et al.  Delirium: guidelines for general hospitals. , 2007, Journal of psychosomatic research.

[19]  N. Frasure-smith,et al.  Effects of citalopram and interpersonal psychotherapy on depression in patients with coronary artery disease: the Canadian Cardiac Randomized Evaluation of Antidepressant and Psychotherapy Efficacy (CREATE) trial. , 2007, JAMA.

[20]  I. Kloszewska,et al.  Preoperative predictors of delirium after cardiac surgery: a preliminary study. , 2006, General hospital psychiatry.

[21]  L. Sands,et al.  The Role of Postoperative Analgesia in Delirium and Cognitive Decline in Elderly Patients: A Systematic Review , 2006, Anesthesia and analgesia.

[22]  S. Scarrow,et al.  Delirium in the Postoperative Cardiac Patient: A Review , 2005, Journal of cardiac surgery.

[23]  P. Kranke,et al.  Single-Dose Parenteral Pharmacological Interventions for the Prevention of Postoperative Shivering: A Quantitative Systematic Review of Randomized Controlled Trials , 2004, Anesthesia and analgesia.

[24]  K. Alagiakrishnan,et al.  An approach to drug induced delirium in the elderly , 2004, Postgraduate Medical Journal.

[25]  M. Schuurmans,et al.  The Measurement of Delirium: Review of Scales , 2003, Research and Theory for Nursing Practice.

[26]  R. Habib,et al.  Adverse effects of low hematocrit during cardiopulmonary bypass in the adult: should current practice be changed? , 2003, The Journal of thoracic and cardiovascular surgery.

[27]  Christianna S. Williams,et al.  The role of adherence on the effectiveness of nonpharmacologic interventions: evidence from the delirium prevention trial. , 2003, Archives of internal medicine.

[28]  W. Frishman,et al.  Neuropsychiatric Effects of Cardiovascular Drug Therapy , 2003, Cardiology in review.

[29]  R. Califf,et al.  Sertraline treatment of major depression in patients with acute MI or unstable angina , 2002, European Neuropsychopharmacology.

[30]  A H Glassman,et al.  Antipsychotic drugs: prolonged QTc interval, torsade de pointes, and sudden death. , 2001, The American journal of psychiatry.

[31]  S. Inouye,et al.  Cognitive and other adverse effects of diphenhydramine use in hospitalized older patients. , 2001, Archives of internal medicine.

[32]  P. Trzepacz,et al.  Validation of the Delirium Rating Scale-revised-98: comparison with the delirium rating scale and the cognitive test for delirium. , 2001, The Journal of neuropsychiatry and clinical neurosciences.

[33]  K. Anstrom,et al.  Outcomes of cardiac surgery in patients > or = 80 years: results from the National Cardiovascular Network. , 2000, Journal of the American College of Cardiology.

[34]  I. Karlsson.  Drugs That Induce Delirium , 1999, Dementia and Geriatric Cognitive Disorders.

[35]  J. Habbema,et al.  Incidence of and preoperative predictors for delirium after cardiac surgery. , 1999, Journal of psychosomatic research.

[36]  M. Dutkiewicz,et al.  The delirious cardiac surgical patient: theoretical aspects and principles of management. , 1998, The Journal of cardiovascular nursing.

[37]  N. Starr,et al.  Perioperative determinants of morbidity and mortality in elderly patients undergoing cardiac surgery* , 1998, Critical care medicine.

[38]  V. Neelon,et al.  The NEECHAM Confusion Scale: construction, validation, and clinical testing. , 1996, Nursing research.

[39]  S. Rauch,et al.  Delirium during intra-aortic balloon pump therapy. Incidence and management. , 1992, Psychosomatics.

[40]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[41]  R. M. Kaiser,et al.  Atypical antipsychotics for the treatment of delirious elders. , 2008, Journal of the American Medical Directors Association.

[42]  N. Doll,et al.  Predictors of delirium after cardiac surgery delirium: effect of beating-heart (off-pump) surgery. , 2004, The Journal of thoracic and cardiovascular surgery.