Postoperative Delirium in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting According to the Anesthetic Agent: A Retrospective Study

• Published in: Journal of cardiothoracic and vascular anesthesia 2017-12, Vol.31 (6), p.1988-1995
• Main Authors: Oh, Chung-Sik, MD, PhD, Park, Sewon, MD, Wan Hong, Seung, MD, Kang, Woon-Seok, MD, PhD, Yoon, Tae-Gyoon, MD, PhD, Kim, Seong-Hyop, MD, PhD
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Anesthesia & Perioperative Care; Anesthetics - administration & dosage; Anesthetics - adverse effects; Coronary Artery Bypass, Off-Pump - adverse effects; Coronary Artery Bypass, Off-Pump - trends; Critical Care; Delirium - chemically induced; Delirium - diagnosis; Delirium - etiology; Female; Humans; Male; Methyl Ethers - administration & dosage; Methyl Ethers - adverse effects; off-pump coronary artery bypass grafting; Postoperative Complications - chemically induced; Postoperative Complications - diagnosis; Postoperative Complications - etiology; postoperative delirium; propofol; Propofol - administration & dosage; Propofol - adverse effects; Retrospective Studies; sevoflurane
• ISSN: 1053-0770; 1532-8422
• DOI: 10.1053/j.jvca.2017.02.047

Objective To evaluate the effect of two anesthetic agents (sevoflurane or propofol) on postoperative delirium (POD) in patients undergoing off-pump coronary artery bypass grafting (CABG). Design Retrospective observational design. Setting University hospital. Participants Two hundred ninety-two patients undergoing off-pump CABG who were anesthetized with sevoflurane or propofol. Methods Incidence of POD, laboratory data, and pre-, intra-, and 24-hour postoperative clinical variables were reviewed retrospectively. The independent predictors of POD were evaluated. Measurements and Main Results The cumulative incidence of POD after off-pump CABG was 10.6% (31 of 292 patients) and the incidence rates of POD were not statistically significant in the sevoflurane and propofol groups (13% [20 of 156 patients] and 8% [11 of 136 patients], respectively; p = 0.137). Other variables, including the laboratory and clinical data also did not differ significantly between the anesthetic groups. Age ≥75 years (odds ratio [OR], 4.84; 95% confidence interval [CI], 1.44-16.27; p = 0.011), postoperative pneumonia (OR, 10.84; 95% CI, 3.32-35.34; p < 0.001), 6 or more packed red blood cell units transfusion in the first 24 hours postoperatively (OR, 5.30; 95% CI, 1.32-21.27; p = 0.019), and 24-hour postoperative albumin