Investigating the correlation of delirium after cardiac surgery with memories and posttraumatic stress disorder consequences of intensive care unit: A prospective cohort study

• Published in: Intensive & critical care nursing 2024-06, Vol.82, p.103632-103632, Article 103632
• Main Authors: Su, Li-Jing, Chen, Mei-Jing, Yang, Rong, Zou, Hong, Chen, Ting-Ting, Li, Sai-Lan, Xin, Hui-Ning, Hu, Rong-Fang
• Format: Article
• Language: English
• Subjects: Cardiac surgery; Clinical medicine; Cognitive ability; Cohort analysis; Confusion; Delirium; Emotions; Heart surgery; Hospital costs; Hospitalization; Hyperarousal; Intensive care; Intensive care unit; Interviews; Intrusion; Memories; Memory; Patients; Post traumatic stress disorder; Posttraumatic stress disorder; Prevention programs; Surgery; Ventilators
• ISSN: 0964-3397; 1532-4036
• DOI: 10.1016/j.iccn.2024.103632

To explore the differences in post-intensive care unit memory and posttraumatic stress disorder symptoms between patients with and without delirium, and assess the correlations between the two. Prospective cohort observation study. A cardiac intensive care unit of a tertiary hospital in China. We enrolled 318 consecutive patients after cardiac surgery between December 2017 and March 2019. Delirium was assessed using the Confusion Assessment Method for the ICU from intensive care unit admission to discharge. Intensive care unit memory was assessed using the ICU-Memory Tool through face-to-face interviews one week after discharge. Posttraumatic stress disorder was measured telephonically using the Impact of Events Scale-revised questionnaire at three months post-discharge. Eighty patients each in the delirium and non-delirium groups were enrolled for follow-up interviews. Patients with delirium had vaguer memories of pre-intensive care unit admission and of their stay, and recollected more memories of feelings (vs. without delirium). Posttraumatic stress disorder was diagnosed in 14 patients with and in seven without delirium, with non-significant differences between groups. Delirium did not influence post-intensive care unit factual, feeling, and delusional memories, nor posttraumatic stress disorder and hyperarousal, intrusion, and avoidance. The memories of feelings were positively correlated with the last three (r = 0.285, r = 0.390 and r = 0.373, respectively). Patients with delirium had vague intensive care unit memories. Memories of feelings were positively correlated with symptoms of hyperarousal, intrusion, and avoidance. Delirium did not influence factual, feeling, or delusional memories nor posttraumatic stress disorder incidence and symptoms. Interventions are needed to reduce the impact of vague memory in patients with post-intensive care unit delirium. Memories of feelings should be focused on because of their correlation with hyperarousal, intrusion, and avoidance. Delirium prevention and early recognition measures are suggested.