Anxiety does not up risk of post-surgery delirium: study

NEW YORK (Reuters Health) - Older patients often suffer delirium after heart surgery, but this seems to be unrelated to pre-surgery anxiety and depression, according to a new study.

“Delirium is a common psychiatric complication after cardiac surgery,” note Dr. Koen Milisen, of Katholieke Universiteit Leuven, Belgium, and colleagues.

“Special attention” must be paid to delirium after heart surgery, because the syndrome is associated with poor outcomes, including higher rates of post-surgery complications, longer hospital stay, and higher death rates, they say.

In a long-term study involving 104 elderly patients admitted for heart surgery, Milisen’s team found that 27 patients, or 26 percent, suffered postoperative delirium for a median of 2 days.

Before surgery, 56 percent of patients had symptoms consistent with anxiety and 25 percent had generalized anxiety. Overall, a little more than 15 percent of subjects reported pre-surgery depressive symptoms.

According to Milisen and colleagues, there was no association between anxiety or depression before surgery and the occurrence of delirium after surgery.

“Patients and their families have to realize that delirium is a common, serious, but in most cases, a transient problem, as distinguished from dementia,” Milisen said.

“Given that delirium is associated with an increased length of hospitalization, a higher likelihood to be discharged to a nursing home, and a higher mortality risk, health professionals should actively screen for presence of delirium and implement the necessary interventions,” Milisen told Reuters Health.

“Despite its high prevalence, delirium is an underestimated problem within healthcare,” he added. “Given the known impact of delirium on poor outcomes, healthcare professionals would benefit from innovative training programs to learn to adequately manage patients with delirium.”

SOURCE: Journal of the American Geriatrics Society, December 2008.

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