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Fortschr Neurol Psychiatr 2017; 85(05): 274-279
DOI: 10.1055/s-0043-103084
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Risikofaktoren des postoperativen Deliriums in der Herzchirurgie.

Risk Factors for Postoperative Delirium after Cardiac Surgery
Christian Gernhardt
1   Klinik für Psychiatrie und Psychotherapie, Universität Lübeck
,
Sophie Kluge
1   Klinik für Psychiatrie und Psychotherapie, Universität Lübeck
,
Mira Meon
1   Klinik für Psychiatrie und Psychotherapie, Universität Lübeck
,
Claudia Schmidtke
2   Kardiochirurgie, Herzzentrum der Segeberger Kliniken Gruppe, Bad Segeberg
,
Antje Karluß
3   Klinik für Herzchirurgie, Universität Lübeck
,
Beate Sedemund-Adib
4   Klinik für Anästhesiologie, Universität Lübeck
,
Tilman Wetterling
5   Psychiatrie, Vivantes Klinikum Kaulsdorf, Berlin
,
Hans-Hinrich Sievers
6   Klinik für Kardiochirurgie, Universität Lübeck
,
Klaus Junghanns
1   Klinik für Psychiatrie und Psychotherapie, Universität Lübeck
› Author Affiliations
Further Information

Publication History

Publication Date:
23 May 2017 (online)

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Zusammenfassung

Hintergrund Das Delir ist eine häufige Komplikation nach Herzoperationen und mit negativen Folgen wie erhöhter Mortalität und Morbidität verbunden. Daher ist die Kenntnis von Risikofaktoren für präventive Maßnahmen erforderlich.

Fragestellung Welches sind prädisponierende Risikofaktoren des Delirs?

Methodik Prospektive Longitudinalstudie an 241 elektiven herzchirurgischen Patienten mit präoperativer Erhebung potenzieller Risikofaktoren und zweifach täglicher Delirmessung über die ersten 5 postoperativen Tage.

Ergebnisse 13 % der Patienten erlitten ein Delir. Verminderte kognitive Leistungsfähigkeit (OR: 3,80; 95 %-KI: 1,66 – 8,66), höhere Komorbidität (OR: 1,36; 95 %-KI: 1,07 – 1,73) und höheres Alter (OR: 1,08; 95 %-KI: 1,02 – 1,13) konnten als Risikofaktoren für ein Delir ermittelt werden.

Schlussfolgerung Ein Delir nach Herzoperation ist häufig. Insbesondere kognitiv eingeschränkte, kränkere, ältere Patienten sind betroffen.

Summary

Background Delirium is a common psychiatric disorder after cardiac surgery and predisposes patients to increased mortality and morbidity. Its prevention requires knowledge of the risk factors involved.

Objective What are preoperative risk factors for postoperative delirium after cardiac surgery?

Methods Prospective longitudinal study of 241 elective cardiac surgical patients with preoperative assessment of potential risk factors and delirium assessment twice daily over five postoperative days.

Results 13 % of the patients experienced delirium. Reduced cognitive performance (OR: 3.80; 95 % CI: 1.66 – 8.66), higher comorbidity (OR: 1.36; 95 % CI: 1.07 – 1.7) and higher age (OR: 1.08; 95 % CI: 1.02 – 1.13) increased the risk of delirium.

Conclusion Delirium after cardiac surgery is common. It occurs in particular in patients with low cognitive performance, higher comorbidity and higher age.

Schlüsselwörter

Delir - Risikofaktoren - Herzchirurgie - kognitive Leistungsfähigkeit - Alter - Komorbidität

Key words

delirium - risk factors - cardiosurgery - cognitive performance - age - comorbidity
 

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