Absence of association between whole blood viscosity and delirium after cardiac surgery: a case-controlled study
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RESEARCH ARTICLE
Open Access
Absence of association between whole blood viscosity and delirium after cardiac surgery: a case-controlled study Shokoufeh CheheiliSobbi1,2,3*, Mark van den Boogaard1, Arjen J. C. Slooter4, Henry A. van Swieten2, Linda Ceelen1, Gheorghe Pop3, Wilson F. Abdo1 and Peter Pickkers1
Abstract Background: Delirium after cardiothoracic surgery is common and associated with impaired outcomes. Although several mechanisms have been proposed (including changes in cerebral perfusion), the pathophysiology of postoperative delirium remains unclear. Blood viscosity is related to cerebral perfusion and thereby might contribute to the development of delirium after cardiothoracic surgery. The aim of this study was to investigate whether whole blood viscosity differs between cardiothoracic surgery patients with and without delirium. Methods: In this observational study postoperative whole blood viscosity of patients that developed delirium (cases) were compared with non-delirious cardiothoracic surgery patients (controls). Cases were matched with the controls, yielding a 1:4 case–control study. Serial hematocrit, fibrinogen, and whole blood viscosity were determined pre-operatively and at each postoperative day. Delirium was assessed using the validated Confusion Assessment Method for the Intensive Care Unit or Delirium Screening Observation scale. Results: In total 80 cardiothoracic surgery patients were screened of whom 12 delirious and 48 matched non-delirious patients were included. No significant difference was found between both groups in fibrinogen (p = 0.36), hematocrit (p = 0.23) and the area under curve of the whole blood viscosity between shear rates 0.02 and 50 s-1 (p = 0.80) or between shear rates 0.02 and 5 s-1 (p = 0.78). Conclusion: In this case control study in cardiothoracic surgery patients changes in whole blood viscosity were not associated with the development of delirium. Keywords: Cardiothoracic surgery, Delirium, Intensive care, Medicine, Whole blood viscosity
Background Delirium is a serious neuropsychiatric disorder characterized by an acute onset of altered mental status, hallmarked by difficulty in sustaining attention with typically a fluctuating course [1]. Delirium occurs frequently in hospitalized patients, especially in Intensive Care Unit (ICU) patients [2]. In cardiothoracic surgery the incidence of delirium during the postoperative on the ICU is reported to be between 13 % and 42 % [3, 4]. Postoperative delirium in cardiothoracic surgery patients * Correspondence: [email protected] 1 Department of Intensive Care Medicine, Radboudumc, Nijmegen, The Netherlands 2 Department of Cardiothoracic Surgery, Radboudumc, Nijmegen, The Netherlands Full list of author information is available at the end of the article
is associated with increased length of ICU and hospital stay, increased risk of sternal wound infection, unwanted removal of arterial/venous lines or epicardial electrodes, significantly impaired quality of life and higher longterm morbidity, m
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