Abstract
Rationale Delirium ranks among the most common complications after cardiac surgery. Although various risk factors have been identified, the association between sleep-disordered breathing (SDB) and delirium has barely been examined so far.
Objectives To determine the incidence of postoperative delirium and to identify the risk factors for delirium in patients with and without SDB.
Methods This sub-analysis of the ongoing prospective observational study CONSIDER AF (NCT02877745) examined risk factors for delirium in 141 patients undergoing cardiac surgery. The presence and type of SDB were assessed with a portable SDB monitor the night before surgery. Delirium was prospectively assessed with the validated Confusion Assessment Method for Intensive Care Units on the day of extubation and for a maximum of 3 days.
Results Delirium was diagnosed in 23% of patients: in 16% of patients without SDB, in 13% with obstructive sleep apnoea, and in 49% with central sleep apnoea. Multivariable logistic regression analysis showed that delirium was independently associated with age ≥70 years (Odd's ratio, OR [95% confidence interval, CI]: 5.63 [1.79; 17.68], p=0.003), central sleep apnoea (4.99 [1.41; 17.69], p=0.013), and heart failure (3.3 [1.06; 10.35], p=0.039). Length of hospital stay and time spent in the ICU/IMC were significantly longer for patients with delirium.
Conclusions Amongst the established risk factors for delirium, central sleep apnoea was independently associated with delirium. Our findings contribute to identifying patients at high risk of developing postoperative delirium who may benefit from intensified delirium prevention strategies.
Footnotes
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Conflict of interest: Dr. Tafelmeier reports grants from Philips Respironics, grants from Medical Faculty of the University of Regensburg, during the conduct of the study.
Conflict of interest: Mr. Knapp has nothing to disclose.
Conflict of interest: Mr. Lebek has nothing to disclose.
Conflict of interest: Dr. Floerchinger has nothing to disclose.
Conflict of interest: Dr. Camboni has nothing to disclose.
Conflict of interest: Dr. Creutzenberg has nothing to disclose.
Conflict of interest: Dr. Wittmann has nothing to disclose.
Conflict of interest: Mr. Zeman has nothing to disclose.
Conflict of interest: Prof. Dr. Schmid has nothing to disclose.
Conflict of interest: Prof. Dr. Maier has nothing to disclose.
Conflict of interest: Prof. Dr. Wagner has nothing to disclose.
Conflict of interest: Dr. Arzt reports grants and personal fees from Philips Respironics, grants and personal fees from ResMed, during the conduct of the study.
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