Delirium and pain in patients in the immediate postoperative period of cardiac surgery: prevalence and associated risk factors

Baltazar, Luiz Fernando Sposito Ribeiro; Reis, Gabriel Baeta Branquinho; Paiva, Arthur Marot de; Silva, Pedro Guimarães Moreira da; Souza, Artur Henrique de; Gardenghi, Giulliano

ABSTRACT BACKGROUND AND

OBJECTIVES:

Delirium is an acute mental status change, with fluctuating course and high incidence in cardiac surgery (CS) post-operative (PO) period. Delirium can lead to short and long-term consequences. The aim of this study was to assess the prevalence of delirium and pain and their risk factors on the 1st PO day after CS.

METHODS:

This was a cross-sectional analytical research. To determine the presence of PO delirium, the Confusion Assessment Method modified for Intensive Care Unit setting (CAM-ICU) and the Richmond Agitation Sedation Scale (RASS) were used. PO pain was analyzed using the Visual Analogue Pain Scale (VAS) and the presence of neuropathic components was analyzed using the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scale. After bedside analysis, patients were divided into Delirium (D) and Without Delirium (WD) groups.

RESULTS:

The total number of patients was 79. The prevalence of delirium was 16.5% (95% CI = 9.06 - 26.49%) and the mean number of comorbidities in the preoperative period was a significant risk factor for the occurrence of delirium (D =4.15±2.37 versus WD=2.96±1.78, p 0.04). Another significant risk factor was the group older than 65 years of age, with the occurrence of delirium 1.45 times higher (PR=1.12-1.88, p 0.0014). Regarding pain evaluation, 72.15% (95% CI 60.93 - 81.65%) reported it in the 1st PO day.

CONCLUSION:

The prevalence of delirium was similar to previous studies. The number of previous comorbidities and advanced age were risk factors for delirium. Pain was present predominantly over the sternotomy incision region.

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