The relationship between STS risk score and post-operative delerium in ICU in of pump coronary artery bypass graft surgery

Document Type : Research Paper

Authors

1 1. Associate Professor of Anesthesiology, Mashhad University of Medical Sciences, Mashhad ,Iran.

2 Associate Professor of Anesthesiology, Mashhad University of Medical Sciences, Mashhad ,Iran.

3 Associate Professor of Anesthesiology, Mashhad University of Medical Sciences, Mashhad ,Iran

4 Mashhad University of Medical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.

5 Department of Cardiac Surgery, Mashhad University of Medical Sciences, Mashhad, Iran.

6 Student of Anesthesiology, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Objective: Despite the improvement in postoperative outcomes, delirium is a common neurological complication after cardiac surgery. Therefore, the present study was conducted to investigate the relationship between STS risk score and postoperative delirium in ICU in coronary artery bypass graft surgery.
Methods & Materials: 150 patients between the ages of 18 and 75 who underwent elective off-pump CABG surgery were evaluated for STS risk score during the operation, the anesthesia protocol was the same, the patient's blood pressure was kept in the optimal range (map: 60-80). Delirium in the patient was assessed with a CAM ICU checklist by a trained nurse after extubation. After the operation, the care protocol was the same in the ICU and in the ICU after extubation, the rate of delirium was assessed by the trained nurse.
Results: Frequency male and female was 57 and 93 respectively.  STS, was no significant difference between the two groups .The number of grafts and the length of hospital stay  in the group  was significantly . No significant differences were observed between the two groups.There was a significant correlation between age and weight and STS  . Weight,  height  and body mass index had a significant correlation with STS. The number of pixels received during operation with STS has a significant  correlation. The number of platelets received during operation with EF before surgery and  duration of operation had a significant negative and positive correlation, respectively.
Conclusion:The presence or absence of Delirium did not show a significant difference with STS score. The presence or absence of Delirium did not show a significant difference with STS score.

References

  1. Edmunds Jr LH. Inflammatory response to cardiopulmonary bypass. The Annals of thoracic surgery. 1998 Nov
    1;66(5):S12-6.
    2. Boyle EM, Pohlman TH, Johnson MC, Verrier ED. Endothelial cell injury in cardiovascular surgery: the systemic
    inflammatory response. The Annals of thoracic surgery. 1997 Jan 1;63(1):277-84.
    3. Taylor KM. Central nervous system effects of cardiopulmonary bypass. The Annals of thoracic surgery. 1998 Nov
    1;66(5):S20-4.
  2. 4. Almassi GH, Sommers T, Moritz TE, Shroyer AL, London MJ, Henderson WG, Sethi GK, Grover FL,
    Hammermeister KE. Stroke in cardiac surgical patients: determinants and outcome. The annals of thoracic surgery.
    1999 Aug 1;68(2):391-7.
    5. Szwed K, Pawliszak W, Szwed M, Tomaszewska M, Anisimowicz L, Borkowska A. Reducing delirium and
    cognitive dysfunction after off-pump coronary bypass: A randomized trial. The Journal of thoracic and cardiovascular
    surgery. 2019 Oct 1.
    6. Zhang W, Sun Y, Liu Y, Qiu W, Ye X, Zhang G, Zhang L. A nursing protocol targeting risk factors for reducing
    postoperative delirium in patients following coronary artery bypass grafting: Results of a prospective before-after study.
    International journal of nursing sciences. 2017 Apr 10;4(2):81-7.
    7. Shams J, Rahmani B, Asefi F, Daneshfar S. Catatonia Development In A Schizoaffective Patient Following
    Electroconvulsive Therapy: Case Report.
    8. Traube C, Mauer EA, Gerber LM, Kaur S, Joyce C, Kerson A, Carlo C, Notterman D, Worgall S, Silver G,
    Greenwald BM. Cost associated with pediatric delirium in the intensive care unit. Critical care medicine. 2016
    Dec;44(12):e1175.
    9. Smeets IA, Tan EY, Vossen HG, Leroy PL, Lousberg RH, Van Os J, Schieveld JN. Prolonged stay at the paediatric
    intensive care unit associated with paediatric delirium. European child & adolescent psychiatry. 2010 Apr;19(4):389-93.
    10. O'Brien SM, Shahian DM, Filardo G, Ferraris VA, Haan CK, Rich JB, Normand SL, DeLong ER, Shewan CM,
    Dokholyan RS, Peterson ED. The Society of Thoracic Surgeons 2008 cardiac surgery risk models: part 2—isolated
    valve surgery. The Annals of thoracic surgery. 2009 Jul 1;88(1):S23-42.
    11. Shroyer AL, Coombs LP, Peterson ED, Eiken MC, DeLong ER, Chen A, Ferguson Jr TB, Grover FL, Edwards FH.
    The Society of Thoracic Surgeons: 30-day operative mortality and morbidity risk models. The Annals of thoracic
    surgery. 2003 Jun 1;75(6):1856-65.
    12. Bucerius J, Gummert JF, Borger MA, Walther T, Doll N, Falk V, Schmitt DV, Mohr FW. Predictors of delirium
    after cardiac surgery delirium: effect of beating-heart (off-pump) surgery. The Journal of thoracic and cardiovascular
    surgery. 2004 Jan 1;127(1):57-64.
    13. Stamou SC, Hill PC, Dangas G, Pfister AJ, Boyce SW, Dullum MK, Bafi AS, Corso PJ. Stroke after coronary artery
    bypass. Stroke. 2001;32:1508-13.
    14. Chang YL, Tsai YF, Lin PJ, Chen MC, Liu CY. Prevalence and risk factors for postoperative delirium in a
    cardiovascular intensive care unit. American journal of critical care. 2008 Nov;17(6):567-75.
    15. Farrokhyar F, Wang X, Kent R, Lamy A. Early mortality from off-pump and on-pump coronary bypass surgery in
    Canada: a comparison of the STS and the EuroSCORE risk prediction algorithms. Canadian journal of cardiology. 2007
    Sep 1;23(11):879-83.
    16. Gobran SR, Goldman S, Ferdinand F, Wertan MA, Trace C, Grunkemeier GL, Wu Y, Sutter FP. Outcomes after
    usage of a quality initiative program for off-pump coronary artery bypass surgery: a comparison with on-pump surgery.
    The Annals of thoracic surgery. 2004 Dec 1;78(6):2015-21.
    17. Loponen P, Luther M, Wistbacka JO, Nissinen J, Sintonen H, Huhtala H, Tarkka MR. Postoperative delirium and
    health related quality of life after coronary artery bypass grafting. Scandinavian Cardiovascular Journal. 2008 Jan
    1;42(5):337-44.
Medical Journal of Mashhad university of Medical Sciences
Volume 63, Issue 6
January and February 2021
Pages 2004-2010

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