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<p>Postoperative delirium (POD) is a&#xa0;frequent and clinically highly relevant complication following cardiac surgery, which is associated with increased morbidity, mortality and prolonged intensive care unit and hospital stays; however, the impact of intraoperative and early postoperative factors on POD development in cardiac surgery patients remains incompletely understood. The prospective FINd DElirium RIsk factors (FINDERI) observational study was therefore designed to systematically investigate these factors and their predictive value for POD. Patients aged ≥ 50&#xa0;years with indications for elective cardiac surgery were included and POD was assessed using the Confusion Assessment Method. To identify potential predictors, univariate and multivariable logistic regression analyses as well as machine learning (ML) approaches with cross-validation were applied. Among 490 patients 106 (21.6%) developed POD. Multivariable logistic regression analysis identified advanced age, longer duration of surgery, combined procedures, opening of cardiac chambers, and prolonged ventilation time as independent predictors for POD. A&#xa0;ML–based decision tree highlighted the duration of ventilation and aortic cross-clamping time as key determinants, while LASSO regression additionally identified administration of erythrocyte concentrates and the use of cardiopulmonary bypass as relevant POD predictors. Overall, these findings underscore the importance of potentially modifiable perioperative risk factors in the development of POD. The duration of ventilation in particular is associated with an increased risk of POD and represents a&#xa0;potentially relevant target for future interventional studies aimed at reducing POD risk.</p>

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Intra- und frühe postoperative Prädiktoren für postoperatives Delir in der Herzchirurgie: Ergebnisse der prospektiven FINDERI-Studie

  • 期刊论文

  • 发表日期：

    2026年4月27日

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  • Monika Sadlonova,
  • Paul Itting,
  • Manuel J. Santander,
  • Maria Knierim,
  • Carlotta Derad,
  • Thomas Asendorf,
  • Christopher M. Celano,
  • Niels Hansen,
  • Hermann Esselmann,
  • Stephanie Heinemann,
  • Ingo Kutschka,
  • Jens Wiltfang,
  • Christine A. F. von Arnim,
  • Hassina Baraki

摘要

Postoperative delirium (POD) is a frequent and clinically highly relevant complication following cardiac surgery, which is associated with increased morbidity, mortality and prolonged intensive care unit and hospital stays; however, the impact of intraoperative and early postoperative factors on POD development in cardiac surgery patients remains incompletely understood. The prospective FINd DElirium RIsk factors (FINDERI) observational study was therefore designed to systematically investigate these factors and their predictive value for POD. Patients aged ≥ 50 years with indications for elective cardiac surgery were included and POD was assessed using the Confusion Assessment Method. To identify potential predictors, univariate and multivariable logistic regression analyses as well as machine learning (ML) approaches with cross-validation were applied. Among 490 patients 106 (21.6%) developed POD. Multivariable logistic regression analysis identified advanced age, longer duration of surgery, combined procedures, opening of cardiac chambers, and prolonged ventilation time as independent predictors for POD. A ML–based decision tree highlighted the duration of ventilation and aortic cross-clamping time as key determinants, while LASSO regression additionally identified administration of erythrocyte concentrates and the use of cardiopulmonary bypass as relevant POD predictors. Overall, these findings underscore the importance of potentially modifiable perioperative risk factors in the development of POD. The duration of ventilation in particular is associated with an increased risk of POD and represents a potentially relevant target for future interventional studies aimed at reducing POD risk.