Incidence, Severity and Treatment of Delirium in Cardiac Surgery Patients: A Before-after Study
Delirium is a common yet under diagnosed condition in hospitalized patients, and the incidence have not previously been described in Danish cardiac surgery patients. The present study seeks to describe the incidence and duration of delirium in this group of patients, before and after the introduction of standardized screening tool and a guideline for treatment of delirium after cardiac surgery.
|Study Design:||Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||Incidence, Severity and Treatment of Delirium in Cardiac Surgery Patients: A Before-after Study|
- number of delirium free days [ Time Frame: 14 days ] [ Designated as safety issue: No ]
number of delirium free days are calculated as percentage of length of stay (LOS) in days.
Participants will be followed for the duration of hospital stay, an expected average of 2 weeks
- complication rates [ Time Frame: 14 days ] [ Designated as safety issue: No ]
complications: respiratory, re-operation, infection, acute kidney injury (AKI), cerebral, cardiac, bleeding.
participants will be followed for the duration of hospital stay, an expected average of 2 weeks
|Study Start Date:||April 2012|
|Study Completion Date:||December 2012|
|Primary Completion Date:||October 2012 (Final data collection date for primary outcome measure)|
No Intervention: before
no systematic approach
systematic screening and treatment of delirium
Other: systematic screening and treatment of delirium
systematic screening for delirium with DOS scale and CAM ICU. In case of delirium, treatment according to guidelines.
Delirium is a common yet under diagnosed condition in cardiac surgery patients, and may cause prolonged cognitive impairment and increased risk of complications. Patients are at risk of e.g. pulling catheters and lines and may fall attempting to get out of bed. The aging patient population present with many risk factors for developing delirium, but diagnostic tools have been few. Almost 50% present with hypoactive delirium, which is often not diagnosed, nor treated correctly. To optimize effect, treatment should be initiated early, maintained until clinical improvement is observed, and then tapered gradually. Recently, Delirium Observation Screening scale (DOS scale) was developed and validated in elective cardiac surgery patients in the Netherlands, with interesting results. This encouraged us to evaluate the effects of systematic delirium screening and treatment in cardiac surgery patients. To our knowledge, no prior studies have evaluated use of DOS scale in this context.
OBJECTIVES To evaluate the incidence and severity of delirium, and the effects of standardized treatment in a population of Danish cardiac surgery patients.
|Department of cardiothoracic surgery and intensive care 4142, Rigshospitalet, Blegdamsvej 6|
|Copenhagen, Denmark, 2100|
|Principal Investigator:||Vibeke L Jorgensen, MD, PhD||Resident|