Risk factors for delirium and cognitive decline following coronary artery bypass grafting surgery: A systematic review and meta‐analysis
Journal of the American Heart Association Nov 22, 2020
Greaves D, Psaltis PJ, Davis DHJ, et al. - In patients undergoing coronary artery bypass grafting (CABG), researchers conducted the first meta‐analysis comprehensively investigating preoperative, intraoperative, and postoperative risk or protective factors linked with delirium and cognitive decline (across time). After performing a systematic search of Medline, PsycINFO, EMBASE, and Cochrane (March 26, 2019), they identified 97 relevant studies, comprising data from 60,479 patients who underwent CABG, for inclusion. Moderate to large and statistically significant risk factors for delirium were preoperative cognitive impairment, depression, stroke history, and higher European System for Cardiac Operative Risk Evaluation (EuroSCORE) score; intraoperative increase in intubation time; and postoperative presence of arrhythmia and increased days in the intensive care unit. Higher preoperative cognitive performance was protective for delirium. Moderate to large and statistically significant risk factors for acute cognitive decline were preoperative depression and older age, intraoperative increase in intubation time, and postoperative presence of delirium and increased days in the intensive care unit.
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