Risk for Postoperative Delirium Related to Comorbidities in Older Adult Cardiac Patients: Systematic Review

Disciplines

Geriatric Nursing | Medicine and Health Sciences | Nursing | Psychiatric and Mental Health Nursing

Abstract (300 words maximum)

Background/objective: Delirium is defined as a sudden onset of confusion due to disruption in normal brain functioning. Although highly prevalent in post-operative patients, most significantly the older adult population, limited research exists explaining why its onset occurs. Due to its broadness, this study serves to determine what specific comorbidities contribute to the development of post-operative delirium in older adults after cardiac surgeries.

Methods: Research was conducted through PubMed and EBSCO. The possible Boolean operators used were “cardiac or post cardiac surgery”, “postoperative delirium or confusion or cognitive decline” and “risk factors or comorbidities or chronic illness or healthy”. Studies were narrowed to a specific group of elderly patients and the occurrence of post-operative delirium after cardiac surgery in those with comorbidities. The following scales were used to determine level of delirium after surgery: DSM5, Confusion Assessment Method, MMSE, Richmond Agitation Sedation Scale, and the Delirium Observation Scale.

Results: Thirteen articles were selected for the study. The following comorbidities were identified in the studies: Diabetes mellitus, atrial fibrillation, depression, impaired olfaction, pre-existing cerebrovascular disease, pre-existing cardiovascular disease, insomnia, and frailty.

Conclusion: Among all of the older adults studied, there was a strong relationship between comorbidities and the development of postoperative delirium.

Keywords: postoperative delirium, elderly patients, cardiac surgery, comorbidities

Academic department under which the project should be listed

WCHHS - Nursing

Primary Investigator (PI) Name

Mary Ramos

Additional Faculty

Jenna Shackleford, PhD, RN, jshackle@kennesaw.edu

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Risk for Postoperative Delirium Related to Comorbidities in Older Adult Cardiac Patients: Systematic Review

Background/objective: Delirium is defined as a sudden onset of confusion due to disruption in normal brain functioning. Although highly prevalent in post-operative patients, most significantly the older adult population, limited research exists explaining why its onset occurs. Due to its broadness, this study serves to determine what specific comorbidities contribute to the development of post-operative delirium in older adults after cardiac surgeries.

Methods: Research was conducted through PubMed and EBSCO. The possible Boolean operators used were “cardiac or post cardiac surgery”, “postoperative delirium or confusion or cognitive decline” and “risk factors or comorbidities or chronic illness or healthy”. Studies were narrowed to a specific group of elderly patients and the occurrence of post-operative delirium after cardiac surgery in those with comorbidities. The following scales were used to determine level of delirium after surgery: DSM5, Confusion Assessment Method, MMSE, Richmond Agitation Sedation Scale, and the Delirium Observation Scale.

Results: Thirteen articles were selected for the study. The following comorbidities were identified in the studies: Diabetes mellitus, atrial fibrillation, depression, impaired olfaction, pre-existing cerebrovascular disease, pre-existing cardiovascular disease, insomnia, and frailty.

Conclusion: Among all of the older adults studied, there was a strong relationship between comorbidities and the development of postoperative delirium.

Keywords: postoperative delirium, elderly patients, cardiac surgery, comorbidities