Department of Cardio Thoracic Surgery, Medisch Spectrum Twente, Enschede, The Netherlands.
Ann Thorac Surg. 2012 Mar;93(3):705-11. doi: 10.1016/j.athoracsur.2011.07.006. Epub 2011 Oct 10.
Delirium is a transient mental syndrome characterized by disturbances in consciousness, cognition, and perception. The risk that delirium will develop is increased in patients who undergo cardiac operations, especially the elderly. Generally, delirium during hospital admission is independently associated with many negative consequences, such as higher mortality, increased length of hospital stay, nursing home placement after admission, and cognitive and functional decline.
This prospective follow-up study used the Short Form 36-Item questionnaire, the Cognitive Failure Questionnaire, and a purpose-designed questionnaire to assess 300 patients who underwent elective cardiac operations at 6 months after the procedure. Postoperative delirium developed in 52 patients (17%). Mortality and readmission were also assessed.
Delirium after cardiac procedures is associated with increased mortality (13.5% vs 2.0% in patients without), more hospital readmissions (45.7% vs 26.5%), and reduced quality of life. It is also associated with reduced cognitive functioning, including failures in attention, memory, perception, and motor function, and with functional dysfunction such as independency in activities of daily living and mobility.
Postoperative delirium after cardiac operations is associated with many important consequences. These findings provide justification for intervention studies to evaluate whether delirium prevention, early recognition, or treatment strategies might improve postoperative functional and cognitive function.
谵妄是一种以意识、认知和知觉障碍为特征的短暂性精神综合征。在接受心脏手术的患者中，尤其是老年人，谵妄的风险会增加。一般来说，住院期间的谵妄与许多负面后果独立相关，如死亡率更高、住院时间延长、住院后安置在疗养院、认知和功能下降。
本前瞻性随访研究使用了 36 项简短形式问卷、认知失败问卷和专门设计的问卷，对 300 名接受择期心脏手术的患者在手术后 6 个月进行评估。52 名患者（17%）发生了术后谵妄。还评估了死亡率和再入院情况。
心脏手术后的谵妄与死亡率增加（有谵妄的患者为 13.5%，无谵妄的患者为 2.0%）、更多的医院再入院（有谵妄的患者为 45.7%，无谵妄的患者为 26.5%）和生活质量降低相关。它还与认知功能下降有关，包括注意力、记忆、感知和运动功能的障碍，以及日常生活活动和移动能力的功能障碍。
心脏手术后的术后谵妄与许多重要后果相关。这些发现为干预研究提供了依据，以评估预防谵妄、早期识别或治疗策略是否可能改善术后的功能和认知功能。
