Gabor ZilahiOrsolya MiskolciMartin LenihanAogan O MuircheartaighWahid AltafFauzi OthmanBrian MarshRoisin Ni Mhuircheartaigh2024-05-272024-05-27201520/12/20191053-0770https://oarep.usim.edu.my/handle/123456789/3346Background. Prior to the introduction of a formal screening tool (Confusion Assessment Method - Intensive Care Unit; CAM-ICU) a retrospective chart review from 2013 detected delirium in 12% of our post-cardiac surgical patients. We hypothesized that a) formal screening would reveal a higher incidence, and b) some modifiable pre and intraoperative risk factors may be target for intervention. Aims. 1. Measure the impact of the introduction of the CAM-ICU tool in our ICU/HDU on the detection of delirium in this patient group. 2. Study the clinical and psychosocial history of patients who developed delirium to distinguish fixed and modifiable risk factors in our patient population. 3. Use these data to develop a ‘delirium bundle’ for ICU/HDU staff to improve the detection of post-operative delirium. Methods. Informed consent for collection of perioperative data and post-operative CAM-ICU testing was obtained from 101 patients presenting for elective cardiac surgery over four months period (01.09.2014 - 31.12.2014). After consenting the patients, a pre-operative questionnaire gathered details of each patient’s smoking and alcohol use, their need for glasses or a hearing aid, any history of depression or anxiety, or psychoactive medication use. Other important intra and postoperative parameters were also collected. The CAM-ICU assessment was carried out daily unless delirium was diagnosed, in which case it was carried out twice a day until delirium resolved. There was no change in the perioperative medical management. Results. Use of the CAM-ICU tool increased our detection of delirium in this patient group from 12% to 21.7%. The median duration of delirium was 48 hours (range 12-552). Those diagnosed with delirium did not have a significantly different profile of proposed psychosocial risk factors. Factors that were significantly different in those patients diagnosed with delirium were generally not modifiable, i.e. higher Euro Score I & II, longer duration of cardiopulmonary bypass, intraoperative blood loss and moderate or high inotropic support following CPB. Conclusion. Our hypothesis that a history of alcohol or nicotine dependence or the need for sensory aids may increase the risk of delirium was not supported by our study. However, increased vigilance in patients with identified fixed risk factors is an important component of the implementation of our new delirium bundle.en-USArticles69s6929