Incidence of cognitive dysfunction after cardiac surgery

• Grant number: 21/08168-4
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: October 01, 2021
• End date: September 30, 2022
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: José Otávio Costa Auler Junior
• Grantee: Pedro Oliveira Dias Martins
• Host Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

Cognitive Disfunction or Postoperative Delirium is an acute neurological disturbance, defined by fluctuating impairment of awareness and attention. This condition has organic causes such as infections, surgeries or medications, and may present itself with other neurological disturbances, for example, memory loss, alterations in the sleep-wake cycle, mood, and perception. The cognitive dysfunction is frequent in the post-operatory of great surgeries as cardiological ones, especially in elderly patients and those with many comorbidities. Delirium is also related to a series of complications such as higher hospitalization time, higher morbidity and mortality, higher hospitalization costs, and, in some cases, it may lead to dementia. In this context, several screening tests and protective conducts can be applied to prevent conditions, reduce the incidence, identify and treat triggering causes. In the Heart Institute of Clinicas Hospital, a high frequency of immediate postoperative delirium is observed. Although there is a perception of high incidence, there isn't enough statistical data to support a prevention process yet. Therefore, this study's goal is to verify the incidence of delirium in a sample of 300 patients, over 18 years old, among a universe of 3000 operated in 2019. Electronic medical records of patients submitted to myocardial revascularization, valvuloplasty or valve replacement, aortic surgery, and combined operations, will be examined actively for this occurrence. The primary objective is to identify delirium incidence by sex, age, surgery type, clinical history, and comorbidity. Data will be registered in excel spreadsheets for post statistical analysis. We estimate delirium's incidence among 26%, in view of 25,65% incidence found by Kotfis, K. et al. For a 95% confidence interval and p-value<0,05, the required sample size calculated was 296 and the statistical method that will be employed in proportion. Posteriorly, a chi-square test will be used to compare incidence between groups according to sex, age, surgery type, clinical history, and comorbidity. (AU)