DELIRIUM AFTER CARDIAC-SURGERY - A CRITICAL-REVIEW

Numerous articles have been published investigating the incidence of a nd risk factors for delirium after cardiac surgery. Smith and Dimsdale reviewed the literature on postcardiotomy delirium in 1987 using a me ta-analysis of 44 research studies. However, doubts about their method s and results caused the authors to re-examine the literature using th ese 44 references as well as computerized literature searches to gathe r research and review papers from medical journals. Delirium after car diac surgery appeared to be ill-defined in most of these studies. The methods and instruments used to assess delirium proved to be very diff erent, and the patient samples were rather heterogeneous. Therefore, i n most cases, the results are not comparable. Only a small number of t he studies that were examined fit the criteria for statistical meta-an alysis. On the basis of our analysis, a tentative conclusion may be dr awn that the incidence of postcardiotomy delirium has declined slightl y and that no strong risk factors have yet been identified.