Evidence map›Paper›PMID 42029600›Full record

ReviewMedical sciences (Basel, Switzerland)2026

Postoperative Delirium After Cardiac Surgery: Psychiatric Vulnerability, Biological Mechanisms, and Prevention Strategies.

Vasileios Leivaditis, Anastasios Sepetis, Francesk Mulita, Athanasios Papatriantafyllou, Sofoklis Mitsos, Periklis Tomos, Konstantinos Grapatsas, Ejona Shaska, Elias Liolis, Efstratios Koletsis and 1 more

Abstract readReview
In one paragraph

Review in Medical sciences (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
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

11 authors.

Vasileios LeivaditisDepartment of Cardiothoracic and Vascular Surgery, Westpfalz Klinikum, 67655 Kaiserslautern, Germany.ORCID 0000-0001-8692-0059
Anastasios SepetisPostgraduate Health and Social Care Management Program, Department of Business Administration, University of West Attica, 12244 Athens, Greece.ORCID 0000-0002-8882-7242
Francesk MulitaDepartment of General Surgery, General Hospital of Eastern Achaia-Unit of Aigio, 25100 Aigio, Greece.ORCID 0000-0001-7198-2628
Athanasios PapatriantafyllouDepartment of Cardiothoracic and Vascular Surgery, Westpfalz Klinikum, 67655 Kaiserslautern, Germany.
Sofoklis MitsosDepartment of Thoracic Surgery, Attikon General Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece.ORCID 0000-0002-0606-7287
Periklis TomosDepartment of Thoracic Surgery, Attikon General Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece.
Konstantinos GrapatsasDepartment of Thoracic Surgery and Thoracic Endoscopy, Ruhrlandklinik, West German Lung Center, University Hospital Essen, University Duisburg-Essen, 45141 Essen, Germany.
Ejona ShaskaDepartment of Psychiatry, "Ali Mihali" Psychiatric Hospital, 9401 Vlora, Albania.
Elias LiolisDepartment of Oncology, General University Hospital of Patras, 26504 Patras, Greece.
Efstratios KoletsisDepartment of Cardiothoracic Surgery, General University Hospital of Patras, 26504 Patras, Greece.ORCID 0000-0003-1660-4047
Nikolaos BaikoussisDepartment of Cardiac Surgery, Ippokrateio General Hospital of Athens, 11527 Athens, Greece.ORCID 0000-0001-5645-662X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDelirium is one of the most common and serious neuropsychiatric complications following cardiac surgery. It is associated with increased mortality, prolonged intensive care unit (ICU) and hospital stay, long-term cognitive decline, and reduced quality of life. AIMS AND

objectivesThe aim of this study is to synthesize current evidence on the epidemiology, psychiatric and psychosocial risk factors, biological mechanisms, perioperative modifiers, prevention strategies, and long-term outcomes of delirium after cardiac surgery, with particular emphasis on its role as a marker of brain vulnerability. MATERIALS AND

methodsA narrative literature review was conducted using articles published between 1990 and 2025, identified through the PubMed and ScienceDirect databases. The search strategy included the terms "delirium," "cardiac surgery," "psychiatric disorders," and "cognitive impairment."

resultsRecent evidence suggests that approximately one quarter of patients undergoing cardiac surgery develop delirium, with hypoactive forms frequently remaining underrecognized in clinical practice. Pre-existing depression, cognitive impairment, substance use disorders, low educational level, frailty, and social isolation significantly increase the risk of postoperative delirium. Within a stress-diathesis framework, peripheral physiological insults may be reflected centrally as acute brain dysfunction in vulnerable individuals. Modifiable perioperative factors include sedative choice and depth, as well as sleep and circadian disruption. Multicomponent non-pharmacological interventions, early mobilization, structured psychiatric and cognitive screening, and dexmedetomidine-based sedation have demonstrated consistent efficacy in reducing the incidence and/or duration of delirium. Furthermore, delirium has been associated with persistent cognitive and psychiatric morbidity, functional decline, and increased long-term mortality.

conclusionsDelirium following cardiac surgery is a multifactorial syndrome with significant short- and long-term consequences. A comprehensive, multidisciplinary approach integrating biological, psychiatric, and perioperative perspectives is essential for effective risk stratification, prevention, and long-term follow-up.

Indexed as

Cardiac Surgical ProceduresDeliriumPostoperative ComplicationsHumansQuality of LifeRisk Factorscardiac surgerycognitive impairmentdeliriumdepressiondexmedetomidineICUneuroinflammationpostoperative cognitive dysfunction

Identifiers

PMID42029600
PMCPMC13108142

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.