The incidence and consequences of mental disturbances in elderly patients post cardiac surgery - A comparison with younger patients

Background: Limited data exist about the incidence and consequences of ment al confusion following open heart surgery in different age groups. Likewise , little is known about preoperative predictors of mental confusion. Methods: Two-hundred consecutive patients, aged greater than or equal to 75 years (Group 1), and 400 procedure- and Sender-matched younger patients (G roup 2) who underwent coronary or valvular surgery were included in a prosp ective study. The relation between postoperative mental confusion, mortalit y, morbidity, and quality of life was studied. Results: Mental confusion was present in 11.8% Group 2 and 22.6% Group 1 pa tients. The incidence was higher after valvular surgery. Preoperative risk factors in Group 1 patients were diabetes mellitus, a history of heart fail ure, weak carotid pulsations, and repeat surgery. Late mortality, after a m edian follow-up duration of 31 months, was significantly worse in patients who were confused, which was related to the underlying disease. Recovery of quality of life was clearly diminished in elderly patients with confusion in contrast to younger patients. Conclusion: Postoperative mental confusion has a high incidence in the elde rly population and is associated with a diminished quality of life.