Delirium after primary percutaneous coronary intervention in aged individuals with acute ST‑segment elevation myocardial infarction: A retrospective study

Li,Sheng; Zhang,Xiao‑Hong; Zhou,Gen‑Dong; Wang,Jian‑Fei

doi:10.3892/etm.2019.7398

Delirium after primary percutaneous coronary intervention in aged individuals with acute ST‑segment elevation myocardial infarction: A retrospective study

Authors:
- Sheng Li
- Xiao‑Hong Zhang
- Gen‑Dong Zhou
- Jian‑Fei Wang
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Affiliations: Department of Cardiology, The Third Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230061, P.R. China
Published online on: March 14, 2019 https://doi.org/10.3892/etm.2019.7398
Pages: 3807-3813

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Abstract

The present prospective study aimed to investigate the incidence and risk factors of delirium after primary percutaneous coronary intervention (PCI) in older adults with acute ST‑segment elevation myocardial infarction (STEMI). A total of 111 patients (age, ≥65 years) with acute STEMI following primary PCI were included in the present study. Neurocognitive testing was performed using the Mini‑mental State Examination on the first day of hospitalization. Post‑operative delirium was assessed using the Confusion Assessment Method for the Intensive Care Unit within the first four post‑operative days. A total of 32 patients (28.8%) developed delirium after primary PCI. The independent predictors of delirium were older age [odds ratio (OR)=1.192, 95% confidence interval (CI)=1.07‑1.328, P=0.001], living alone (OR=4.827, 95% CI=1.315‑17.725, P=0.018), history of alcohol abuse (OR=3.875, 95% CI=1.168‑12.857, P=0.026), longer duration of primary PCI (OR=1.152, 95% CI=1.077‑1.232, P<0.001) and post‑operative pain (current pain; OR=7.663, 95% CI=1.432‑41.02, P=0.017). Compared to the patients without delirium, the participants who developed delirium had longer hospital stays and a higher rate of re‑admission within 30 days after discharge. The mortality within one year after discharge (one‑year mortality) was similar between patients with and without delirium. In conclusion, older patients (age, ≥65 years) with acute STEMI are at a relatively high risk of delirium following primary PCI. Higher age (≥65 years), living alone, history of alcohol dependence, longer length of primary PCI (>50 min) and post‑operative pain (current pain) were determined to be risk factors for delirium after primary PCI in the present cohort.

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