Imran Khan, Ammar Hameed Khan, Saira Gull, Sameena Kausar, Madeeha Iqbal, Abdul Waheed.
Incidence and Predictors of Delirium in Postoperative Coronary Artery Bypass Surgery patients in Pakistani Population.
Pak J Med Health Sci Jan ;8(1):92-7.

Aim: To study the incidence and predictors of Delirium in post-operative period after Coronary Artery Bypass Surgery in Pakistani population. Methods: All the patients undergoing CABG were included in this prospective observational study from April 2012 to April 2013. Patients having a redo surgery or emergency surgery were excluded. Patients were assessed by a psychiatrist preoperatively through mini mental scoring system to exclude those with psychiatric disorder preoperatively. Pre-operative, operative and post-operative variables were recorded in a prospective study at a tertiary care hospital. Delirium was diagnosed in post op period using the DSM IV criteria. The results were subjected to logistic regression and Odds ratio was calculated for various variables. Results: A total of 735(n=735) patients were included in the study of which 577(78.5%) were male while 154(21%) were female. Mean age was 55.64±9.65. Delirium was detected in 161(22%) patients. Logistic regression results indicated that Male gender (OR:1.07,CI 95%:0.205-5.58), Diabetes (OR:4.9,CI 95%:1.25-19.27), previous history of stoke (OR:1.49, CI 95%:0.000-0.00), smoking (OR:3.0, CI 95%:0.54-17.8), below normal haemoglobin level (OR:1.16, CI 95%:0.70-1.97), cross clamp time (OR:1.007, CI 95%: 0.96-1.06), number of bottom end anastamosis (OR:1.58, CI 95%:0.74-3.4), intubation time( 6.92 ± 2.82 Vs 18.6 ±15.5) and creatinine (OR:1.04, CI 95%: 0.49-2.18) were independently predicting delirium after coronary artery bypass procedure. Patients with delirium had significantly more length of stay in the ICU (12.62±5.23 in Delirious patients Vs 6.11±1.072, p=0.001 in non-delirious patients). Conclusion: Delirium is a well-known complication in post Op CABG patients leading to longer hospital stay. Independent predictors of delirium are Male gender, Diabetes mellitus, Previous history of Stroke, Smoking, low Heamoglobin level, Cross clamp time, number of distal anastomosis, creatinine level and intubation time.

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