Stroke, Seizures, Hallucinations and Postoperative Delirium as Neurological Complications after Cardiac Surgery and Percutaneous Valve Replacement
(1) Background: Neurological complications such as acute ischemic stroke or postoperative delirium are frequent after cardiac surgery or percutaneous valve replacement. This study aimed to identify corresponding risk factors. (2) Methods: 297 patients with percutaneous valve replacement or cardiac s...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/9/11/365 |
| _version_ | 1797467807144738816 |
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| author | Johannes Teller Maria Magdalena Gabriel Svea-Dorothee Schimmelpfennig Hans Laser Ralf Lichtinghagen Andreas Schäfer Christine Fegbeutel Karin Weissenborn Carolin Jung Lukas Hinken Hans Worthmann |
| author_facet | Johannes Teller Maria Magdalena Gabriel Svea-Dorothee Schimmelpfennig Hans Laser Ralf Lichtinghagen Andreas Schäfer Christine Fegbeutel Karin Weissenborn Carolin Jung Lukas Hinken Hans Worthmann |
| author_sort | Johannes Teller |
| collection | DOAJ |
| description | (1) Background: Neurological complications such as acute ischemic stroke or postoperative delirium are frequent after cardiac surgery or percutaneous valve replacement. This study aimed to identify corresponding risk factors. (2) Methods: 297 patients with percutaneous valve replacement or cardiac surgery were postoperatively screened for neurological complications such as delirium, stroke, seizures and hallucinations twice daily for three days. Pre- and perioperative risk factors were evaluated in a multivariate model. (3) Results: Neurological complications occurred in 43.8% (<i>n</i> = 130) as composed of delirium (43.43%, <i>n</i> = 129), stroke (2.7%, <i>n</i> = 8), seizures (1.35%, <i>n</i> = 4) and real hallucinations (3.36%, <i>n</i> = 10). Multiple logistic regression revealed an association of neurological complications with lower Montreal Cognitive Assessment scores (Exp(B) 2.042; 95% CI, 1.183–3.525, <i>p</i> = 0.010), older age (Exp(B) 1.071; 95% CI, 1.036–1.107, <i>p</i> < 0.001), red blood cell transfusions until postoperative day 3 (Exp(B) 1.157; 95% CI, 1.030–1.300, <i>p</i> = 0.014), history of heart failure (Exp(B) 1.985; 95% CI, 1.130–3.487, <i>p</i> = 0.017) and increased CRP levels (Exp(B) 1.004; 95% CI, 1.000–1.008, <i>p</i> = 0.037). (4) Conclusions: Postoperative delirium remains a frequent complication after cardiac surgery, while stroke and seizures occur rarely. A preoperative risk profile including older age, history of heart failure and cognitive impairment was identified for a complicated postoperative course. However, the impact of an intense inflammatory response must not be neglected. |
| first_indexed | 2024-03-09T18:58:56Z |
| format | Article |
| id | doaj.art-be2b607eeb8247fbaeb76f7ff753d435 |
| institution | Directory Open Access Journal |
| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-09T18:58:56Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-be2b607eeb8247fbaeb76f7ff753d4352023-11-24T05:13:57ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252022-10-0191136510.3390/jcdd9110365Stroke, Seizures, Hallucinations and Postoperative Delirium as Neurological Complications after Cardiac Surgery and Percutaneous Valve ReplacementJohannes Teller0Maria Magdalena Gabriel1Svea-Dorothee Schimmelpfennig2Hans Laser3Ralf Lichtinghagen4Andreas Schäfer5Christine Fegbeutel6Karin Weissenborn7Carolin Jung8Lukas Hinken9Hans Worthmann10Department of Neurology, Hannover Medical School, 30625 Hannover, GermanyDepartment of Neurology, Hannover Medical School, 30625 Hannover, GermanyDepartment of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, 30625 Hannover, GermanyDepartment for Educational and Scientific IT Systems, Centre for Information Management, Hannover Medical School, 30625 Hannover, GermanyInstitute of Clinical Chemistry, Hannover Medical School, 30625 Hannover, GermanyCardiac Arrest Center, Department of Cardiology and Angiology, Hannover Medical School, 30625 Hannover, GermanyDepartment of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, GermanyDepartment of Neurology, Hannover Medical School, 30625 Hannover, GermanyDepartment of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, 30625 Hannover, GermanyDepartment of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, 30625 Hannover, GermanyDepartment of Neurology, Hannover Medical School, 30625 Hannover, Germany(1) Background: Neurological complications such as acute ischemic stroke or postoperative delirium are frequent after cardiac surgery or percutaneous valve replacement. This study aimed to identify corresponding risk factors. (2) Methods: 297 patients with percutaneous valve replacement or cardiac surgery were postoperatively screened for neurological complications such as delirium, stroke, seizures and hallucinations twice daily for three days. Pre- and perioperative risk factors were evaluated in a multivariate model. (3) Results: Neurological complications occurred in 43.8% (<i>n</i> = 130) as composed of delirium (43.43%, <i>n</i> = 129), stroke (2.7%, <i>n</i> = 8), seizures (1.35%, <i>n</i> = 4) and real hallucinations (3.36%, <i>n</i> = 10). Multiple logistic regression revealed an association of neurological complications with lower Montreal Cognitive Assessment scores (Exp(B) 2.042; 95% CI, 1.183–3.525, <i>p</i> = 0.010), older age (Exp(B) 1.071; 95% CI, 1.036–1.107, <i>p</i> < 0.001), red blood cell transfusions until postoperative day 3 (Exp(B) 1.157; 95% CI, 1.030–1.300, <i>p</i> = 0.014), history of heart failure (Exp(B) 1.985; 95% CI, 1.130–3.487, <i>p</i> = 0.017) and increased CRP levels (Exp(B) 1.004; 95% CI, 1.000–1.008, <i>p</i> = 0.037). (4) Conclusions: Postoperative delirium remains a frequent complication after cardiac surgery, while stroke and seizures occur rarely. A preoperative risk profile including older age, history of heart failure and cognitive impairment was identified for a complicated postoperative course. However, the impact of an intense inflammatory response must not be neglected.https://www.mdpi.com/2308-3425/9/11/365cardiac surgerypercutaneous valve replacementseizurehallucinationstrokepostoperative delirium |
| spellingShingle | Johannes Teller Maria Magdalena Gabriel Svea-Dorothee Schimmelpfennig Hans Laser Ralf Lichtinghagen Andreas Schäfer Christine Fegbeutel Karin Weissenborn Carolin Jung Lukas Hinken Hans Worthmann Stroke, Seizures, Hallucinations and Postoperative Delirium as Neurological Complications after Cardiac Surgery and Percutaneous Valve Replacement Journal of Cardiovascular Development and Disease cardiac surgery percutaneous valve replacement seizure hallucination stroke postoperative delirium |
| title | Stroke, Seizures, Hallucinations and Postoperative Delirium as Neurological Complications after Cardiac Surgery and Percutaneous Valve Replacement |
| title_full | Stroke, Seizures, Hallucinations and Postoperative Delirium as Neurological Complications after Cardiac Surgery and Percutaneous Valve Replacement |
| title_fullStr | Stroke, Seizures, Hallucinations and Postoperative Delirium as Neurological Complications after Cardiac Surgery and Percutaneous Valve Replacement |
| title_full_unstemmed | Stroke, Seizures, Hallucinations and Postoperative Delirium as Neurological Complications after Cardiac Surgery and Percutaneous Valve Replacement |
| title_short | Stroke, Seizures, Hallucinations and Postoperative Delirium as Neurological Complications after Cardiac Surgery and Percutaneous Valve Replacement |
| title_sort | stroke seizures hallucinations and postoperative delirium as neurological complications after cardiac surgery and percutaneous valve replacement |
| topic | cardiac surgery percutaneous valve replacement seizure hallucination stroke postoperative delirium |
| url | https://www.mdpi.com/2308-3425/9/11/365 |
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