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Learning Objective 1: describe the impact of delirium after cardiac surgery on the postoperative course of patients.
Learning Objective 2: identify factors related to the development of postoperative delirium after cardiac surgery.
Methods: Research Design: Descriptive correlational design
Sample: 436 males and 220 females (N= 656) between the ages of 29 and 91 years who had cardiac surgery from January 10, 2011 to October 30, 2011 at Mission Hospital in Asheville, NC. Patients had the following procedures performed with the cardiopulmonary bypass machine: CABG, valve repair/ replacement, and CABG with valve repair/replacement. Of the total sample, 161 patients (24.54%) developed postoperative delirium. Charts were reviewed retrospectively and data were analyzed using t- test and Fisher’s exact test.
Results: The difference between postoperative delirium and no postoperative delirium groups along the following outcomes were significant: length of stay after surgery (p=.000), occurrence of falls (p=.001), patients discharged to a skilled nursing facility/long term acute care/rehabilitation center (p=.000), patients discharged to home with home health (p=.013), and patients who required inpatient physical therapy (p=.000). The following demographic variables were found to be related to postoperative delirium after cardiac surgery: age, cardiopulmonary bypass time, number of pre existing medical conditions; past medical history of: arrhythmias, CHF, and renal disease; type of surgery: CABG and CABG with valve surgery; and medications given after surgery: PO Benzodiazepines, IV Ketorolac, and Ambien.
Conclusion: Patients who develop postoperative delirium are more likely to experience poorer outcomes. They are more likely to fall, stay longer after surgery, be discharged to a nursing facility, be discharged to home with home health, and require inpatient physical therapy.
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