Evidence map›Paper›PMID 33164631›Full record

SynthesisJournal of the American Heart Association2020

Risk Factors for Delirium and Cognitive Decline Following Coronary Artery Bypass Grafting Surgery: A Systematic Review and Meta-Analysis.

Danielle Greaves, Peter J Psaltis, Daniel H J Davis, Tyler J Ross, Erica S Ghezzi, Amit Lampit, Ashleigh E Smith, Hannah A D Keage

2 registry-linked trialsOpen access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of the American Heart Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 98 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
98citing papers in PubMed, 11 pooled it
8.3field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04963036 naunknown statusnot on this mapstarted 2021, after this paper: background citation

Impact of Nociception Level (NOL)-Guided Remifentanil Infusion and Entropy-guided Propofol Infusion on Intraoperative Arterial Pressure and Vasopressor Necessity A Prospective, Randomized, Controlled Trial.

TypeinterventionalSponsorCentre Hospitalier Universitaire Saint PierreRan2021 to 2022Enrolled50ConditionsHead and Neck Surgery, Maxillofacial SurgeryArmsEntropy and NOL-Guided Goal Directed Anesthesia, Standard of Care Group (Entropy and blinded NOL)
NCT06275139 naunknown statusnot on this mapstarted 2023, after this paper: background citation

Integrated Assessment of Cervicocerebral Vessels by Multidisciplinary Team to Improve the Brain Injury for CAGB Patients With High Risk of Stroke (IACV Study)

TypeinterventionalSponsorChina National Center for Cardiovascular DiseasesRan2023 to 2024Enrolled348ConditionsCoronary Disease, Coronary Artery Bypass, Strokes ThromboticArmsIntegrated Assessment of Cervicocerebral Vessels
3 · Its place in the literature

Who cites it

98 citing papers in PubMed, 11 syntheses or guidelines pooled it, 158 citations in OpenAlex.

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38 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 3 countries.

Danielle GreavesCognitive Ageing and Impairment Neurosciences Laboratory, Justice and Society Academic Unit University of South Australia Adelaide Australia.
Peter J PsaltisVascular Research Centre Lifelong Health Theme South Australian Health and Medical Research Institute Adelaide Australia.
Daniel H J DavisMedical Reasearch Council Unit for Lifelong Health and Ageing Unit at UCL London United Kingdom.
Tyler J RossCognitive Ageing and Impairment Neurosciences Laboratory, Justice and Society Academic Unit University of South Australia Adelaide Australia.
Erica S GhezziCognitive Ageing and Impairment Neurosciences Laboratory, Justice and Society Academic Unit University of South Australia Adelaide Australia.
Amit LampitAcademic Unit for Psychiatry of Old Age Department of Psychiatry University of Melbourne Melbourne Australia.
Ashleigh E SmithCognitive Ageing and Impairment Neurosciences Laboratory, Justice and Society Academic Unit University of South Australia Adelaide Australia.
Hannah A D KeageCognitive Ageing and Impairment Neurosciences Laboratory, Justice and Society Academic Unit University of South Australia Adelaide Australia.
University of South Australia · AUMRC Unit for Lifelong Health and Ageing · GBRoyal Adelaide Hospital · AUThe University of Melbourne · AU

Funding

Wellcome Trust 107467/Z/15/ZWellcome Trust WT107467
6 · The paper itself

Abstract

Background Coronary artery bypass grafting (CABG) is known to improve heart function and quality of life, while rates of surgery-related mortality are low. However, delirium and cognitive decline are common complications. We sought to identify preoperative, intraoperative, and postoperative risk or protective factors associated with delirium and cognitive decline (across time) in patients undergoing CABG. Methods and Results We conducted a systematic search of Medline, PsycINFO, EMBASE, and Cochrane (March 26, 2019) for peer-reviewed, English publications reporting post-CABG delirium or cognitive decline data, for at least one risk factor. Random-effects meta-analyses estimated pooled odds ratio for categorical data and mean difference or standardized mean difference for continuous data. Ninety-seven studies, comprising data from 60 479 patients who underwent CABG, were included. Moderate to large and statistically significant risk factors for delirium were as follows: (1) preoperative cognitive impairment, depression, stroke history, and higher European System for Cardiac Operative Risk Evaluation (EuroSCORE) score, (2) intraoperative increase in intubation time, and (3) postoperative presence of arrythmia and increased days in the intensive care unit; higher preoperative cognitive performance was protective for delirium. Moderate to large and statistically significant risk factors for acute cognitive decline were as follows: (1) preoperative depression and older age, (2) intraoperative increase in intubation time, and (3) postoperative presence of delirium and increased days in the intensive care unit. Presence of depression preoperatively was a moderate risk factor for midterm (1-6 months) post-CABG cognitive decline. Conclusions This meta-analysis identified several key risk factors for delirium and cognitive decline following CABG, most of which are nonmodifiable. Future research should target preoperative risk factors, such as depression or cognitive impairment, which are potentially modifiable. Registration URL: https://www.crd.york.ac.uk/prosp​ero/; Unique identifier: CRD42020149276.

Indexed as

Cognitive DysfunctionCoronary Artery BypassCoronary Artery DiseaseDeliriumHumansPostoperative ComplicationsRisk Factorscognitive declinecoronary artery bypass graftingdeliriummeta‐analysis

Identifiers

PMID33164631
PMCPMC7763731
OpenAlexW3100035060

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.