Journal Article Annotations
2021, 1st Quarter
Annotations by Sarah Andrews, MD and Shehzad K. Niazi, MD
This prospective cohort study performed secondary analysis of the “Breath Again” study, evaluating adults undergoing first-time lung transplantation between January 2010 and April 2017. While patients were in the ICU, delirium was identified through the Confusion Assessment Method for the ICU (CAM-ICU). Associations between delirium, depressive symptoms, Health-Related Quality of Life (HRQL), and mortality were examined. Post-operative delirium was evident in 14% of the participants, increased risk of mortality, and worsened HRQL.
Strength and weaknesses:
The study identified delirium as a risk factor for mortality and decreased quality of life. This study had several strengths including the large cohort of lung transplant patients. There was limited missing data. Some limitations include the lower-than-expected rate of delirium as compared to other published studies.
This study is relevant for C-L psychiatrists who evaluate or manage lung transplant patients. While evaluating patients pre-transplant, steps should be taken to help reduce risk of post-operative delirium. Interventions include simplifying medication regimens and avoiding deliriogenic medications such as benzodiazepine and antihistamines. There is significant need to further explore the association between delirium and mortality.
Type of study:
Prospective cohort study