ORIGINAL ARTICLE   

Chirurgia 2019 August;32(4):185-90

DOI: 10.23736/S0394-9508.18.04862-3

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Delirium is a predictor of mortality in patients with uncomplicated type B aortic dissection

Ken NAKAMURA ✉, Tetsuro UCHIDA, Azumi HAMASAKI, Mitsuaki SADAHIRO

Division of Cardiovascular Surgery, Nihonkai General Hospital, Sakata City, Yamagata, Japan

BACKGROUND: Delirium is common in cardiovascular disease. We compared outcomes in patients who were medically treated for uncomplicated Stanford type B acute aortic dissection, with and without delirium.
METHODS: Between July 2004 and March 2016, 270 patients were admitted to our university hospital with a diagnosis of acute aortic dissection. The 124 patients were a diagnosis of type B acute aortic dissection. Of these, 100 patients were medically treated for two weeks. Evaluations were performed using the Richmond Agitation-Sedation Scale (RASS) and the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).
RESULTS: Delirium prevalence was 42% (42/100). At baseline, patients who developed delirium were more likely to be older, require longer ICU stays (4.9±4.3 vs 2.3±2.5; P<.001), require mechanical ventilation (33% vs 5%; P<.05), and have higher aortic-related mortality after the acute phase (P<.05). Aortic rupture (4%, 4/100) and type A aortic dissection (2%, 2/100) only occurred in the delirium group.
CONCLUSIONS: In patients with Stanford type B aortic dissection, delirium was common and was associated with lower survival and a higher occurrence of major adverse aortic events. Early assessment of delirium may help identify patients with type B aortic dissection who are at risk for poor outcomes.

KEY WORDS: Aneurysm, dissecting - Disease management - Delirium