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Risk factors and impact of an acute confusional state in the postoperative period of cardiac surgery


An acute confusional state (ACS) has been a frequent finding in patients undergoing cardiac surgery (CS), which, according to the literature, has resulted in a greater number of complications and in an increase in hospitalization and length of stay in the intensive care unit (ICU).


To assess the predisposing factors, the incidence and the influence of ACS in patients undergoing CS, and to assess the impact of ACS on the length of stay, morbidity, and mortality.

Case series and methods

A classical cohort with data of 592 patients consecutively collected, 102 of whom had ACS undergoing CS from June 2000 to March 2003. Forty-six variables previously defined in the major prognostic indices in the literature were compared, and their correlation with ACS was analyzed. The statistical analysis comprised univariate analysis with the chi-square test, Student t test, Mann–Whitney test, and Pearson test followed by logistic regression.


The univariate analysis showed significance of the following variables: chronic obstructive pulmonary disease (P = 0.03), advanced age, and multiple organ dysfunction syndrome (MODS) score. After logistic regression, only the MODS score (P = 0.01) and age (P = 0.005) showed significance. In regard to length of stay in the ICU, the results were as follows: up to 3 days, 41.17% of the patients with ACS and 65.91% of those without ACS; from 4 to 7 days, 38.23% of the patients with ACS and 21.42% of those without ACS; and longer than 8 days, 20.58% of the patients with ACS and 12.65% of those without ACS, with significance (P = 0.00002).


ACS relates to age, MODS score, and longer length of stay in the ICU.

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Silva Filho, D., Barbirato, G., Campos, L. et al. Risk factors and impact of an acute confusional state in the postoperative period of cardiac surgery. Crit Care 7, P73 (2003).

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  • Public Health
  • Logistic Regression
  • Intensive Care Unit
  • Chronic Obstructive Pulmonary Disease
  • Univariate Analysis