Impact of delirium on postoperative frailty and long term cardiovascular events after cardiac surgery.
Postoperative delirium (POD) is a common and critical complication after cardiac surgery. However, the relationship between POD and postoperative physical frailty and the effect of both on long-term clinical outcomes have not been fully explored.We aimed to examine the associations among POD, postop...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2017-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5747483?pdf=render |
| _version_ | 1818041991670267904 |
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| author | Masato Ogawa Kazuhiro P Izawa Seimi Satomi-Kobayashi Yasunori Tsuboi Kodai Komaki Yasuko Gotake Yoshitada Sakai Hiroshi Tanaka Yutaka Okita |
| author_facet | Masato Ogawa Kazuhiro P Izawa Seimi Satomi-Kobayashi Yasunori Tsuboi Kodai Komaki Yasuko Gotake Yoshitada Sakai Hiroshi Tanaka Yutaka Okita |
| author_sort | Masato Ogawa |
| collection | DOAJ |
| description | Postoperative delirium (POD) is a common and critical complication after cardiac surgery. However, the relationship between POD and postoperative physical frailty and the effect of both on long-term clinical outcomes have not been fully explored.We aimed to examine the associations among POD, postoperative frailty, and major adverse cardiac events (MACE).This was a prospective cohort study.We studied 329 consecutive patients undergoing elective cardiac surgery. The intensive care delirium screening checklist was used to assess POD. Postoperative frailty was defined by handgrip strength and walking speed. Patients were subsequently followed-up to detect MACE.POD was present in 13.2%, while the incidence of postoperative frailty was 27.0%. POD was independently associated with development of postoperative frailty (adjusted odds ratio = 2.98). During follow-up, MACE occurred in 14.1% of all participants. On multivariate Cox proportional hazard analysis, POD (adjusted hazard ratio (HR) = 3.36), postoperative frailty (HR = 2.21), postoperative complications (HR = 1.54), and left ventricular ejection fraction (HR = 0.95) were independently associated with increased risk of MACE.It is a single-center study with a risk of bias. We did not investigate follow up cognitive function.POD was a predictor of postoperative frailty after cardiac surgery. Both postoperative frailty and POD were associated with the incidence of MACE, while POD was the stronger predictor of MACE. Thus, POD and frailty play critical roles in the risk stratification of patients undergoing cardiac surgery. |
| first_indexed | 2024-12-10T08:39:13Z |
| format | Article |
| id | doaj.art-3b7959beb7a04566b1ded6c86695b852 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-10T08:39:13Z |
| publishDate | 2017-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-3b7959beb7a04566b1ded6c86695b8522022-12-22T01:55:54ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-011212e019035910.1371/journal.pone.0190359Impact of delirium on postoperative frailty and long term cardiovascular events after cardiac surgery.Masato OgawaKazuhiro P IzawaSeimi Satomi-KobayashiYasunori TsuboiKodai KomakiYasuko GotakeYoshitada SakaiHiroshi TanakaYutaka OkitaPostoperative delirium (POD) is a common and critical complication after cardiac surgery. However, the relationship between POD and postoperative physical frailty and the effect of both on long-term clinical outcomes have not been fully explored.We aimed to examine the associations among POD, postoperative frailty, and major adverse cardiac events (MACE).This was a prospective cohort study.We studied 329 consecutive patients undergoing elective cardiac surgery. The intensive care delirium screening checklist was used to assess POD. Postoperative frailty was defined by handgrip strength and walking speed. Patients were subsequently followed-up to detect MACE.POD was present in 13.2%, while the incidence of postoperative frailty was 27.0%. POD was independently associated with development of postoperative frailty (adjusted odds ratio = 2.98). During follow-up, MACE occurred in 14.1% of all participants. On multivariate Cox proportional hazard analysis, POD (adjusted hazard ratio (HR) = 3.36), postoperative frailty (HR = 2.21), postoperative complications (HR = 1.54), and left ventricular ejection fraction (HR = 0.95) were independently associated with increased risk of MACE.It is a single-center study with a risk of bias. We did not investigate follow up cognitive function.POD was a predictor of postoperative frailty after cardiac surgery. Both postoperative frailty and POD were associated with the incidence of MACE, while POD was the stronger predictor of MACE. Thus, POD and frailty play critical roles in the risk stratification of patients undergoing cardiac surgery.http://europepmc.org/articles/PMC5747483?pdf=render |
| spellingShingle | Masato Ogawa Kazuhiro P Izawa Seimi Satomi-Kobayashi Yasunori Tsuboi Kodai Komaki Yasuko Gotake Yoshitada Sakai Hiroshi Tanaka Yutaka Okita Impact of delirium on postoperative frailty and long term cardiovascular events after cardiac surgery. PLoS ONE |
| title | Impact of delirium on postoperative frailty and long term cardiovascular events after cardiac surgery. |
| title_full | Impact of delirium on postoperative frailty and long term cardiovascular events after cardiac surgery. |
| title_fullStr | Impact of delirium on postoperative frailty and long term cardiovascular events after cardiac surgery. |
| title_full_unstemmed | Impact of delirium on postoperative frailty and long term cardiovascular events after cardiac surgery. |
| title_short | Impact of delirium on postoperative frailty and long term cardiovascular events after cardiac surgery. |
| title_sort | impact of delirium on postoperative frailty and long term cardiovascular events after cardiac surgery |
| url | http://europepmc.org/articles/PMC5747483?pdf=render |
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