Sex Differences in the Incidence of Postoperative Delirium after Cardiac Surgery: A Pooled Analyses of Clinical Trials
Year: 2023
Type: article
Abstract: Editor -Postoperative delirium after cardiac surgery is associated with long-term cognitive deficits, prolonged hospitalization and institutionalization, and increased mortality.Although mechanisms to explain postoperative delirium are unclear, studies suggest underlying patient vulnerabilities such as frailty, depression and subclinical Alzheimer's dementia (AD) contribute to delirium. 1 In prospective observational studies of delirium after cardiac surgery, multiple studies 2,3 reported a higher proportion of females with delirium.The data reported in these studies suggest that female subjects had a 1.36 (95% CI: 1.09 -1.70) and 3.74 (1.42 -9.82) times greater risk of developing postoperative delirium compared to their male counterparts, respectively.2,3 This finding contrasts with data from noncardiac surgeries, 4 where males are frequently reported to be at a relatively higher risk of developing delirium.We note that studies included in reviews and meta-analyses of postoperative delirium after cardiac surgery were not designed to measure sex differences, and many do not report data to permit independent post hoc analyses.Thus, sex as a predisposing risk factor for postoperative delirium after cardiac surgery has been poorly understood.In this pooled analyses study, we combined data from three published clinical trials (the DEXACET, 5 Hyperoxia 6 and MINDDS 7 ) across two institutions, each involving patients who underwent non-emergent cardiac surgeries.Patients were screened for postoperative delirium using the Confusion Assessment Method (CAM, for MINDDS 7 ) or a combination of CAM and its ICU equivalent (CAM-ICU, for the DEXACET 5 and Hyperoxia 6 trials).In this report, postoperative delirium was defined as per the respective protocols of the trials included.Unadjusted relative risk, standardized risk ratio and their corresponding 95% confidence intervals were estimated by Wald's methods of unconditional maximum
Source: Anesthesiology
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4385520406