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YAŞLI KARDİYAK CERRAHİ HASTALARINDA DELİRYUM RİSKİNİ ARTTIRAN FAKTÖRLER: SİSTEMATİK DERLEME

Year 2020, Volume: 3 Issue: 2, 157 - 166, 30.09.2020

Abstract

Kardiyak cerrahi sonrası deliryum insidansının %3-70 arasında değiştiği belirtilmektedir ve bu riskin yaşlı hastalarda fazla olduğu bilinmektedir.
Bu derlemede, yaşlı kardiyak cerrahi hastalarında deliryum riskini artıran faktörleri belirleyen araştırmaların sistematik olarak incelenmesi
amaçlandı. Konuyla ilgili makalelere ulaşmak için “Pubmed”, “Science Direct”, “Google Scholar”, “Ulakbim Türk Tıp Dizini”, “Türk Medline”
ve “Google Akademik” veri tabanları “kalp cerrahisi ve deliryum” (cardiac surgery AND delirium) anahtar kelimeleri kullanılarak tarama yapıldı.
Kardiyak cerrahi geçiren yaşlılarda deliryum konusuna yönelik Ocak 2016-Haziran 2020 (son beş yıl) arasında yayınlanmış 486 çalışmaya
ulaşıldı. Araştırmaya dahil edilme kriterlerine uygun beş yayın çalışma kapsamına alındı. Bu çalışmalar kronolojik sıraya göre, örneklem
özellikleri, veri toplama yöntemleri ve elde edilen sonuçları içeren bir düzen içerisinde verildi. İncelenen çalışmalarda; yaş, düşük ejeksiyon
fraksiyonu, diyabet, ekstra kardiyak arteriopati, postoperatif atriyal fibrasyon, pnömoni, yüksek kreatinin, uzamış yatış süresi, düşük eğitim
düzeyi, hipertansiyon, mitral kapak hastalıkları, atriyal fibrasyon, fiziksel zayıflıkla birlikte hafif bilişsel bozukluğun olması, hiperoksi atakları
ve D vitamini eksikliğinin yaşlılarda kardiyak cerrahi sonrası deliryum riskini arttırdığı belirlendi. Yaşlılarda kardiyak cerrahi sonrası deliryum
görülme riskini arttıran ameliyat sürecine bağlı risk faktörlerinin olduğu sonucuna varılmıştır. Kardiyak cerrahi geçiren yaşlı hastalarda deliryum
insidansını ve ameliyat sonrası deliryumun neden olduğu olumsuz sonuçların azaltılabilmesi için standart tanılama yöntemleri kullanılarak
ameliyat sürecinde risk faktörlerinin erken tanılanması önerilmektedir.

Supporting Institution

Bulunmamaktadır

Project Number

Bulunmamaktadır

Thanks

-

References

  • Akarsu Ayazoğlu, T., Tür, H., Bolat, C., Özkaynak, İ., & Candan, M. (2012). Yaşlılarda Kardiyak Cerrahi Sonrası Yoğun Bakımda Deliryum Prevalansı ve Risk Faktörleri. Journal of Experimental and Clinical Medicine, 29(2), 101–107.
  • Balam Yavuz, B. (2010). Deliryum Geriatri Uzmanı Gözüyle. Akademik Geriatri, 178–180.
  • Brown, C. H. (2015). Delirium in the Cardiac Surgical Intensive Care Unit. Curr Opin Anaesthesiol, 27(2), 117–122. https://doi.org/10.1097/ACO.0000000000000061
  • Cerejeira, J., & Mukaetova-Ladinska, E. B. (2011). A Clinical Update on Delirium: From Early Recognition to Effective Management. Nursing Research and Practice, 2011, 1–12. https://doi.org/10.1155/2011/875196
  • EDA and ADS. (2014). The DSM-5 criteria, level of arousal and delirium diagnosis: inclusiveness is safer (European Delirium Association and American Delirium Society). BMC Medicine, 12(1), 141. https://doi.org/10.1186/s12916-014-0141-2
  • Habeeb-Allah, A., & Alshraideh, J. A. (2019). Delirium post-cardiac surgery: Incidence and associated factors. Nursing in Critical Care, November, 1–6. https://doi.org/10.1111/nicc.12492
  • Itagaki, A., Sakurada, K., Matsuhama, M., Yajima, J., Yamashita, T., & Kohzuki, M. (2020). Impact of Frailty and Mild Cognitive Impairment on Delirium After Cardiac Surgery in Older Patients. Journal of Cardiology, 76(2), 147–153.
  • Janssen, T. L., Alberts, A. R., Hooft, L., Mattace-Raso, F. U. S., Mosk, C. A., & Van Der Laan, L. (2019). Prevention of postoperative delirium in elderly patients planned for elective surgery: Systematic review and meta-analysis. Clinical Interventions in Aging, 14, 1095–1117. https://doi.org/10.2147/CIA.S201323
  • Kavasoğlu, T., Vural, Ç., Turan, S., Acar, H. V., Kavasoğlu, K., & Erdemli, M. Ö. (2015). Delirium after open heart surgery. Turkish Journal of Thoracic and Cardiovascular Surgery, 23(4), 658–664. https://doi.org/10.5606/tgkdc.dergisi.2015.10797
  • Koster, S., Henses, A., Schuurmans, M., & Van der Palen, J. (2011). Risk Factors of Delirium after Cardiac Surgery: A Systmatic Review. European Journal of Cardiovascular Nursing, 10(4), 197–204.
  • Kotfis, K., Szylińska, A., Listewnik, M., Strzelbicka, M., Brykczyński, M., Rotter, I., & Żukowski, M. (2018). Early delirium after cardiac surgery: An analysis of incidence and risk factors in elderly (≥65 years) and very elderly (≥80 years) patients. Clinical Interventions in Aging, 13, 1061–1070. https://doi.org/10.2147/CIA.S166909
  • Kupiec, A., Adamik, B., Forkasiewicz-Gardynik, K., & Goździk, W. (2020). Intra-operative hyperoxia and the risk of delirium in elderly patients after cardiac surgery. Aging, 12(8), 7006–7014. https://doi.org/10.18632/AGING.103058
  • Martinez, F., Tobar, C., & Hill, N. (2015). Preventing delirium: Should non-pharmacological, multicomponent interventions be used? A systematic review and meta-analysis of the literature. Age and Ageing, 44(2), 196–204. https://doi.org/10.1093/ageing/afu173
  • Oliveira, F. R., Oliveira, V. H., Oliveira, Í. M., Lima, J. W., Calderaro, D., Gualandro, D. M., & Caramelli, B. (2018). Hypertension, mitral valve disease, atrial fibrillation and low education level predict delirium and worst outcome after cardiac surgery in older adults. BMC Anesthesiology, 18(1), 1–8. https://doi.org/10.1186/s12871-018-0481-0
  • Sarı, N., & Yavuz van Giersbergen, M. (2017). Yaşlılarda Deliryum, Demans ve Depresyonun Değerlendirilmesi ve Hemşirelik Bakım Rehberi. Ege Üniversitesi Hemşirelik Fakültesi Dergisi, 33(3), 138–152.
  • Sugimura, Y., Sipahi, N., Mehdiani, A., Petrov, G., Awe, M., Minol, J., Boeken, U., Korbmacher, B., Lichtenberg, A., & Dalyanoglu, H. (2020). Risk and Consequences of Postoperative Delirium in Cardiac Surgery. Thorac Cardiovasc Surg, 68(5), 1–8.
  • Tuğlu, C., & Yıldırım, E. (2002). Hastanede Yatarak Tedavi Gören Hastalarda Sık Karşılaşılan Psikiyatrik Bir Sendrom: Deliryum. Trakya Üniversitesi Tıp Fakültesi Dergisi, 19(1), 55–64.
  • Tumer, N., Tekeli Kunt, A., Günaydın, S., & Özisik, K. (2020). Preoperative vitamin D Level is Associated with Postoperative Delirium After Cardiac Surgery in Paitents Over 65 Years of Age. The Heart Surgery Forum, 23(3), E264-269.
  • Yavuz Karamanoğlu, A., Gök, F., & Demir Korkmaz, F. (2015). Kalp Cerrahisi Hastalarında Deliryum ve Hemşirelik Bakımı. Ege Üniversitesi Hemşirelik Fakültesi Dergisi, 31(2), 113–129.

FACTORS INCREASING THE RISK OF DELIRIUM RISK IN ELDERLY CARDIAC SURGERY PATIENTS: A SYSTEMATIC REVIEW

Year 2020, Volume: 3 Issue: 2, 157 - 166, 30.09.2020

Abstract

It is stated that the delirium incidence after cardiac surgery varies between 3% -70%. It is known that this risk is high in elderly patients. In this
research, it was aimed to systematically review the articles about the factors that increase delirium risk in the elderly cardiac surgery patients.
We searched the key words cardiac surgery and delirium using “Pubmed”, “Science Direct”, “Google Scholar”, “Ulakbilim Turkish Medical
Index”, “Turkish Medline” and “Google Academic” databases. 486 studies published between January 2016 and June 2020 (last five years),
about delirium in elderly patients after cardiac surgery, were found. Five of these studies which are convenient for review criteria were included
in this review. These studies are arranged chronologically in a manner of sample features, data gaining methods and the results. In result of these
studies; advanced age, patients with lower ejection fraction, diabetes mellitus, extra cardiac arteriopathy, postoperative atrial fibrillation,
pneumonia, patients with higher creatinine levels, longer hospital stay, lower education level, hypertension, mitral valve diseases, physical
durability, cognitive disorders, hyperoxia and vitamin D deficiency increases the risk of delirium after cardiac surgery for elderly patients. We
imported through these studies that there are perioperative risk factors that increase delirium risk after cardiac surgery for elderly patients. It is
highly recommended that early recognition of perioperative risk factors with standard diagnosis techniques is essential to decrease the incidence
of delirium and unfavorable effects of postoperative delirium after cardiac surgery in the elderly.

Project Number

Bulunmamaktadır

References

  • Akarsu Ayazoğlu, T., Tür, H., Bolat, C., Özkaynak, İ., & Candan, M. (2012). Yaşlılarda Kardiyak Cerrahi Sonrası Yoğun Bakımda Deliryum Prevalansı ve Risk Faktörleri. Journal of Experimental and Clinical Medicine, 29(2), 101–107.
  • Balam Yavuz, B. (2010). Deliryum Geriatri Uzmanı Gözüyle. Akademik Geriatri, 178–180.
  • Brown, C. H. (2015). Delirium in the Cardiac Surgical Intensive Care Unit. Curr Opin Anaesthesiol, 27(2), 117–122. https://doi.org/10.1097/ACO.0000000000000061
  • Cerejeira, J., & Mukaetova-Ladinska, E. B. (2011). A Clinical Update on Delirium: From Early Recognition to Effective Management. Nursing Research and Practice, 2011, 1–12. https://doi.org/10.1155/2011/875196
  • EDA and ADS. (2014). The DSM-5 criteria, level of arousal and delirium diagnosis: inclusiveness is safer (European Delirium Association and American Delirium Society). BMC Medicine, 12(1), 141. https://doi.org/10.1186/s12916-014-0141-2
  • Habeeb-Allah, A., & Alshraideh, J. A. (2019). Delirium post-cardiac surgery: Incidence and associated factors. Nursing in Critical Care, November, 1–6. https://doi.org/10.1111/nicc.12492
  • Itagaki, A., Sakurada, K., Matsuhama, M., Yajima, J., Yamashita, T., & Kohzuki, M. (2020). Impact of Frailty and Mild Cognitive Impairment on Delirium After Cardiac Surgery in Older Patients. Journal of Cardiology, 76(2), 147–153.
  • Janssen, T. L., Alberts, A. R., Hooft, L., Mattace-Raso, F. U. S., Mosk, C. A., & Van Der Laan, L. (2019). Prevention of postoperative delirium in elderly patients planned for elective surgery: Systematic review and meta-analysis. Clinical Interventions in Aging, 14, 1095–1117. https://doi.org/10.2147/CIA.S201323
  • Kavasoğlu, T., Vural, Ç., Turan, S., Acar, H. V., Kavasoğlu, K., & Erdemli, M. Ö. (2015). Delirium after open heart surgery. Turkish Journal of Thoracic and Cardiovascular Surgery, 23(4), 658–664. https://doi.org/10.5606/tgkdc.dergisi.2015.10797
  • Koster, S., Henses, A., Schuurmans, M., & Van der Palen, J. (2011). Risk Factors of Delirium after Cardiac Surgery: A Systmatic Review. European Journal of Cardiovascular Nursing, 10(4), 197–204.
  • Kotfis, K., Szylińska, A., Listewnik, M., Strzelbicka, M., Brykczyński, M., Rotter, I., & Żukowski, M. (2018). Early delirium after cardiac surgery: An analysis of incidence and risk factors in elderly (≥65 years) and very elderly (≥80 years) patients. Clinical Interventions in Aging, 13, 1061–1070. https://doi.org/10.2147/CIA.S166909
  • Kupiec, A., Adamik, B., Forkasiewicz-Gardynik, K., & Goździk, W. (2020). Intra-operative hyperoxia and the risk of delirium in elderly patients after cardiac surgery. Aging, 12(8), 7006–7014. https://doi.org/10.18632/AGING.103058
  • Martinez, F., Tobar, C., & Hill, N. (2015). Preventing delirium: Should non-pharmacological, multicomponent interventions be used? A systematic review and meta-analysis of the literature. Age and Ageing, 44(2), 196–204. https://doi.org/10.1093/ageing/afu173
  • Oliveira, F. R., Oliveira, V. H., Oliveira, Í. M., Lima, J. W., Calderaro, D., Gualandro, D. M., & Caramelli, B. (2018). Hypertension, mitral valve disease, atrial fibrillation and low education level predict delirium and worst outcome after cardiac surgery in older adults. BMC Anesthesiology, 18(1), 1–8. https://doi.org/10.1186/s12871-018-0481-0
  • Sarı, N., & Yavuz van Giersbergen, M. (2017). Yaşlılarda Deliryum, Demans ve Depresyonun Değerlendirilmesi ve Hemşirelik Bakım Rehberi. Ege Üniversitesi Hemşirelik Fakültesi Dergisi, 33(3), 138–152.
  • Sugimura, Y., Sipahi, N., Mehdiani, A., Petrov, G., Awe, M., Minol, J., Boeken, U., Korbmacher, B., Lichtenberg, A., & Dalyanoglu, H. (2020). Risk and Consequences of Postoperative Delirium in Cardiac Surgery. Thorac Cardiovasc Surg, 68(5), 1–8.
  • Tuğlu, C., & Yıldırım, E. (2002). Hastanede Yatarak Tedavi Gören Hastalarda Sık Karşılaşılan Psikiyatrik Bir Sendrom: Deliryum. Trakya Üniversitesi Tıp Fakültesi Dergisi, 19(1), 55–64.
  • Tumer, N., Tekeli Kunt, A., Günaydın, S., & Özisik, K. (2020). Preoperative vitamin D Level is Associated with Postoperative Delirium After Cardiac Surgery in Paitents Over 65 Years of Age. The Heart Surgery Forum, 23(3), E264-269.
  • Yavuz Karamanoğlu, A., Gök, F., & Demir Korkmaz, F. (2015). Kalp Cerrahisi Hastalarında Deliryum ve Hemşirelik Bakımı. Ege Üniversitesi Hemşirelik Fakültesi Dergisi, 31(2), 113–129.
There are 19 citations in total.

Details

Primary Language Turkish
Subjects Surgery
Journal Section Articles
Authors

Fatma Nur Tomakin This is me 0000-0003-2791-6396

Elif Deniz Kaçmaz This is me 0000-0001-7630-3532

Aliye Okgün Alcan 0000-0002-6889-363X

Project Number Bulunmamaktadır
Publication Date September 30, 2020
Submission Date August 15, 2020
Published in Issue Year 2020 Volume: 3 Issue: 2

Cite

APA Tomakin, F. N., Kaçmaz, E. D., & Okgün Alcan, A. (2020). YAŞLI KARDİYAK CERRAHİ HASTALARINDA DELİRYUM RİSKİNİ ARTTIRAN FAKTÖRLER: SİSTEMATİK DERLEME. Izmir Democracy University Health Sciences Journal, 3(2), 157-166.

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