AUTHOR=Li Na , Liu Xing , Gao Yuhua , Yin Lingzi , Zhao Wanli , Ma Rongxing , Ni Xinli 

TITLE=Association of electroencephalogram epileptiform discharges during cardiac surgery with postoperative delirium: An observational study

JOURNAL=Frontiers in Surgery

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2022.900122

DOI=10.3389/fsurg.2022.900122

ISSN=2296-875X

ABSTRACT=Background: Delirium is a frequent and serious complication following cardiac surgery involving cardiopulmonary bypass (CPB). Electroencephalography reflects the electrical activity of the cerebral cortex. The impact of electroencephalographic epileptiform discharges during cardiac surgery on postoperative delirium remains unclear. This study was designed to investigate the relationship of intraoperative epileptiform discharges with postoperative delirium in patients undergoing cardiac surgery.
Methods: A total of 76 patients who underwent cardiac surgery under CPB were included. The baseline cognitive status was measured before surgery. Electroencephalograms were monitored continuously from entry into the operating room to the end of surgery. The presence of delirium was assessed through the Confusion Assessment Method or the Confusion Assessment Method for the Intensive Care Unit on the first 3 days after surgery. Univariate and multivariate logistic regression analyses were performed to evaluate the association between epileptiform discharges and delirium.
Results: Delirium occurred in 31% of patients and epileptiform discharges were present in 26% of patients in the study. Patients with delirium had a higher incidence of epileptiform discharges (52.63% vs. 13.95%, P < 0.001) and longer durations of anesthesia and CPB (P = 0.023 and P = 0.015, respectively). In addition, patients with delirium had a longer hospital length of stay and higher incidence of postoperative complications. Multivariate logistic regression analysis showed that age and epileptiform discharges were significantly associated with the incidence of postoperative delirium (odds ratio, 4.75 [1.26 to 17.92], P = 0.022; 5.00 [1.34 to 18.74], P = 0.017, respectively).
Conclusions: Postoperative delirium is significantly related with the occurrence of epileptiform discharges during cardiac surgery.