Effect of Postoperative Delirium on Outcomes After Cardiac Surgery

Purpose:
The study was conducted to determine the effect of postoperative delirium on outcomes after cardiac surgery based on the following outcome measures:length of stay, occurrence of falls, discharge to a nursing facility, discharge to home with home health, and utilization of inpatient physical therapy.

Background/Significance:
Postoperative delirium is a common condition that leads to poor outcomes after surgery. Numerous studies have been conducted on the effect of postoperative delirium on outcomes after non cardiac surgery but there are very few studies examining its effect on outcomes after cardiac surgery. It is very important to study postoperative delirium after cardiac surgery because of its impact on the postoperative course of patients.

Methods:
Sample: The study involved 656 patients who had cardiac surgery from January 10, 2011 to October 30, 2011 at Mission Hospital. The sample consisted of 436 males and 220 females between the ages of 29 and 91. 161 patients developed postoperative delirium. Methods: Electronic medical records of patients were reviewed retrospectively. Documentation of each patient's neurological status was evaluated to determine the development of postoperative delirium. Patients were classified into postoperative delirium and no postoperative delirium groups and were categorized based on various demographic characteristics. Descriptive statistics was used to analyze data.

Results:
The difference between postoperative delirium and no postoperative delirium groups along the following outcome measures were significant: length of stay after surgery (p=.000), occurrence of falls (p=.001), discharge to a skilled nursing facility/long term acute care/rehabilitation center (p=.000), discharge to home with home health (p=.013), and utilization of inpatient physical therapy (p=.000).

Conclusions and Implications for Practice:
Patients who develop postoperative delirium after cardiac surgery are more likely to develop poorer outcomes. To improve the postoperative course of those at risk for and those who develop postoperative delirium, the development of an extensive care plan to address this condition is necessary.