Analysis of nutritional effects and other risk factors for the development of postoperative delirium in patients undergoing coronary arterial bypass grafting: A retrospective secondary analysis

Abstract

<title>Abstract</title> <bold>Background:</bold> Delirium is an acute brain dysfunction associated with increased mortality, morbidity, and long-term cognitive dysfunction. Studies showed that the incidence of post-cardiac surgery delirium (PCSD) might reach up to 70% of patients. This study aims to analyze risk factors contributing to the incidence of PCSD in patients undergoing elective cardiac surgeries. <bold>Methods:</bold> This study is a secondary retrospective cohort analysis that utilizes prospectively collected data from an 8-year follow-up period to investigate the nutritional status of patients undergoing cardiac surgery. Data from 1187 patients was analyzed for risk factors associated with PCSD. The statistical analysis was conducted using R version 4.2.0. A p-value less than 0.05 was considered statistically significant. <bold>Results:</bold> A total of 1,187 patients were included in our analysis based on the dataset. The prevalence of delirium in the sample set was 8% (96/1187). Each parameter underwent univariate analysis, and significant parameters were included in a multivariate logistic regression model. The analysis revealed that parameters like increasing age at <italic>p</italic>&lt; 0.05, with an odds ratio (OR) of 1.05, CI (1.02 -1.07), the aortic cross-clamp time (<italic>p&lt;</italic>0.05) with an OR=1.01 CI [1.01-1.02], longer ventilation hours (p&lt;0.05) with an OR= 1.06 CI [1.02-1.10], hospital and intensive care length of stay with <italic>p&lt;0.05</italic> and, <italic>p&lt;0.001, </italic>respectively to be associated with increased incidence of postoperative delirium. <bold>Conclusion:</bold> There is a significant association between PCSD and various factors such as advanced age, extended duration of aortic cross-clamp, prolonged mechanical ventilation, and increased length of hospitalization in patients undergoing cardiac surgeries.