Correlación de la diabetes mellitus tipo II con el delirio postperatorio en pacientes sometidos a cirugía de revascularización miocárdica

Abstract

Introduction: Postoperative delirium (POD) is a sudden and fluctuating neurocognitive syndrome, with an incidence of up to 54% following coronary artery bypass grafting (CABG), and worsens the recovery in these patients. Among its possible risk factors is type II diabetes mellitus (DM II). However, studies on the association between DM II and POD in these patients are limited. Study objectives: To analyze if there is any association between diabetes mellitus and the occurrence of postoperative delirium in patients undergoing coronary artery bypass surgery. Methods: An analytical, retrospective cross-sectional study with a quantitative approach was conducted. Based on inclusion and exclusion criteria, a final sample of 325 patients who underwent CABG at Alcívar Hospital during the period 2020-2023 was obtained. Results: DM II and the incidence of POD are not associated (p= 0.91); however, in diabetic patients with HbA1c ≥7%, the probability of POD increases up to 4 times (OR 4.92 [2.55–9.81]) (p<0.001), unlike diabetics with HbA1c <7%. HbA1c is not a significant predictor of postoperative mortality (p= 0.35) and its elevated levels do not increase the average length of stay in the ICU (p= 0.12). Conclusion: Patients with type II diabetes mellitus who have their disease under control have the same risk of developing postoperative delirium as non-diabetic patients, as it is poorly controlled disease (HbA1c ≥7%) that is associated with an increased incidence of postoperative delirium, making it a preoperative risk factor in revascularized patients.