Yaşlılarda kardiyak cerrahi sonrası yoğun bakımda deliryumun prevalansı ve risk faktörleri

Deliryum kardiyak cerrahi sonrasi sik gorulen gecici noropsikiyatrik bir sendromdur. Yaslilarda ve yogun bakimda yuksek prevalansina ragmen klinisyenler tarafindan siklikla taninmamakta ya da depresyon, yogun bakim sendromu, demans gibi kritik hastaliklarin beklenen onemsiz komplikasyonlari olarak gorulmektedir. Calismamizin amaci, acik kalp cerrahisi sonrasinda yogun bakim unitesinde, 65 yas ve uzeri hastalarda, prevalans ve deliryum ile iliskili risk faktorlerini belirlemektir. Calismaya 65 yas ve uzeri 217 hasta dahil edildi. Veriler yogun bakim unitesinde konfuzyonu degerlendirme olcegi (YBU-KDO) [The Confusion Assesment Method for the In-tensive Care Unit (CAM-ICU)] ve deliryumun taniminda altin standart olan tum diger psikiyatrik tanilarin da siniflandirildigi, uluslararasi kilavuz olan, ''Diagnostic and Statistical Manual for Mental Disorders (DSM-IV)'' ile olculerek toplandi. Calismada deliryumun prevalansi % 29,5 olarak bulundu. Ileri yas, erkek cinsiyet, yuksek acute physiology and chronic health evaluation II (APACHE II) degeri, New York heart association functional classification (NYHA)>2, serebrovaskuler hastalik, kotu fiziksel durum, aortik cerrahi, ameliyat suresi, iskemi suresi, hematokrit dusuklugu ( 1,2mmol/L), hipoalbuminemi ( 18), immobilizasyon, postoperatif 48. saat medikasyonlar, uyku bozuklugu ve yogun bakimda kalma suresi yaslilarda deliryum gelisiminde risk faktorleri olarak tespit edildi. Acik kalp cerrahisi sonrasi yasli hastalarda gorulen deliryum multifaktoryel bir hastaliktir. Risk faktorlerinin belirlenip kontrol altina alinmasi hastanede yatis ve taburcu olma suresini, morbidite ve en onemlisi mortaliteyi azaltmaktadir. The prevalence and the risk factors for delirium in the elderly after cardiac surgery in intensive care unit Delirium is a neuropsychiatric syndrome and commonly seen after cardiac surgery. In intensive care units, it has a high prevalence in the elderly but is not easily recognized by clinicians or in critically ill patient. Delirium is thought as an expected minor complication of other diseases such as depression, intensive care syndrome, dementia. The goal of this study was to determine the risk factors associated with delirium after open heart surgery in the 65 years and older patients in the intensive care unit. The sample consisted of 217 patients admitted to an intensive care unit. Data were collected using the Confusion Assessment Method (CAM) and the DSM IV. The prevalence of delirium was 29,5% . The risk factors determining the development of delirium in the eldery were detected as, advanced age, male gender, high APACHE II value, NYHA>2, cerebrovascular disease, poor physical condition, aortic surgery, operative time, ischemia time, low hematocrit ( 1.2 mmol/L), hypoalbuminemia ( 18), immobilization, postoperative 48 hours of medications, sleep disturbance and intensive care unit stay. After open heart surgery delirium is a multifactorial disease in elderly patients. In cardiac surgery to identify and control of risk factors reduce the length of hospitalization and discharge. Its most importantly to reduce morbidity, and mortality. J. Exp. Clin. Med., 2012; 29:101-107