CARDIOVASCULAR JOURNAL OF AFRICA • Volume 33, No 6, November/December 2022 AFRICA 299 Results The CAM-ICU scores of all patients are shown in Table 1. The demographic characteristics and clinical data of the patients are summarised in Table 2. There were no differences between the two groups in terms of demographic or clinical data. The pre-operative blood results and haematological parameters of the patients are summarised in Table 3. There were statistically significant differences in the mean pre-operative levels of CRP (p = 0.0001), ESR (p = 0.0001) and MPV (p = 0.0001), and PLR (p = 0.0001) and NLR (p = 0.0001) between the groups. The early postoperative blood results and haematological parameters are shown in Table 4. There were statistically significant differences in the mean pre-operative levels of CRP (p = 0.0001), ESR (p = 0.0001) and MPV (p = 0.0001), and PLR (p = 0.0001) and NLR (p = 0.0001) between the groups. The intra-operative and postoperative data of the patients are summarised in Table 5. There were no differences in terms of aortic cross-clamp time, total CPB time, amount of drainage, amount of blood products used and required inotropic support in the postoperative period (p > 0.05). There were statistically significant differences in the APACHE II score (p = 0.0001), and the length of stay in ICU (p = 0.0001) and hospital (p = 0.0001) between the groups. Manifestations of postoperative delirium occurred in 48 patients (25.7%) within the first 24 hours, in 84 patients (44.9%) between 24 and 48 hours, and in 55 patients (29.4%) between 48 and 72 hours. Neurological events such as transient ischaemic attack, amaurosis fugax, speech disorder, hemiplegia or hemiparesis occurred in hospital and within the first month in eight patients (4.3%) in group 1 and in 12 patients (2.0%) in group 2, indicating a statistically insignificant difference (p = 0.09). Also, mortality occurred in hospital and within the first month in three patients (1.6%) in group 1 and in five patients (0.8%) in group 2, indicating a statistically insignificant difference (p = 0.37). In patients with postoperative delirium and cerebrovascular accident, neurological examination revealed amnesia in five patients, dysarthria in two patients, and amaurosis fugax in one patient. Among the patients with cerebrovascular accident, cranial computed tomography revealed ischaemic infarction in two patients. Table 3. Pre-operative blood results and haematological parameters of patients Pre-operative blood results and haematological parameters Patients with delirium, group 1 (n = 187) Patients without delirium, group 2 (n = 590) p-value Pre-operative haemoglobin (mg/dl) 13.4 ± 1.3 (median: 13.5, range: 10.8–15.7) 13.3 ± 1.4 (median: 13.4, range: 10.6–16.5) 0.056** Pre-operative creatinine (mg/dl) 0.96 ± 0.3 (median: 0.87, range: 0.45–1.76) 0.94 ± 0.2 (median: 0.86, range: 0.45–1.83) 0.57** Pre-operative leucocyte counts (×103 cells/µl) 8.2 ± 1.7 (median: 8.2, range: 4.6–10.9) 8.1 ± 1.7 (median: 8.1, range: 3.4–10.9) 0.47** Pre-operative thrombocyte counts (×103 cells/µl) 225 ± 61 (median: 254, range: 121–412) 261 ± 62 (median: 253, range: 122–443) 0.95** Pre-operative lymphocyte counts (×103 cells/µl) 1.83 ± 0.74 (median: 1.7, range: 0.6–4.9) 1.86 ± 0.71 (median: 1.8, range: 0.4–4.9) 0.47** Pre-operative C-reactive protein (mg/l) 1.06 ± 0.74 (median: 0.79, range: 0.23–4.90) 0.63 ± 0.42 (median: 0.51, range: 0.16–3.67) 0.0001** Pre-operative MPV (fl) 8.6 ± 0.6 (median: 8.7, range: 7.3–10.5) 8.0 ± 0.6 (median: 8.1, range: 6.8–9.6) 0.0001** Pre-operative PLR 151.8 ± 10.5 (median: 153.7, range: 123.8– 174.4) 137.9 ± 10.6 (median: 135.8, range: 109.4– 170.0) 0.0001** Pre-operative NLR 4.5 ± 0.7 (median: 4.5, range: 2.3–6.5) 24.6 ± 4.2 (median: 3.6, range: 1.5–6.1 0.0001** Pre-operative ESR (mm/h) 11.2 ± 4.0 (median: 11.6, range: 2–19) 7.8 ± 4.2 (median: 7.3, range: 2–19) 0.0001** PLR: pre-operative platelet-to-lymphocyte ratio; NLR: neutrophil-to lymphocyte ratio; ESR: erythrocyte sedimentation rate; MPV: mean platelet volume. *Pearson chi-squared test or Fisher’s exact test; **Mann–Whitney U-test. Table 2. Demographic and clinical properties of the patients Characteristics Patients with delirium, group 1 (n = 187) Patients without delirium, group 2 (n = 590) p-value Age (mean ± SD) 59.8 ± 7.4 (median: 60.6, range: 39–75) 59.7 ± 8.7 (median: 60, range: 30–75) 0.82** Male (n, %) 141 (23.6) 456 (76.4) 0.59* Female (n, %) 46 (25.6) 134 (74.4) 0.59* Hypertension (n, %) 53 (28.3) 196 (33.2) 0.21* Diabetes mellitus (n, %) 60 (28.0) 207 (32.7) 0.45* Smoking (n, %) 65 (34.8) 210 (35.6) 0.84* Hyperlipidaemia (n, %) 71 (38) 223 (37.8) 0.97* Ejection fraction (mean ± SD) 55.2 ± 7.8 (median: 55.4, range: 40–68) 55.5 ± 8.0 (median: 55.5, range: 40–68) 0.90** EuroSCORE (mean ± SD) 2.04 ± 1.6 (median: 2.1, range: 0–6) 2.11 ± 1.6 (median: 2.2, range: 0–6) 0.70** Basal heart rate (mean ± SD) 66.6 ± 6.7 (median: 66.9, range: 54–85) 66.6 ± 7.6 (median: 66.2, range: 52–89) 0.82** EuroSCORE: European system for cardiac operative risk evaluation. *Pearson chi-squared test or Fisher’s exact test; **Mann–Whitney U-test. Table 4. Early postoperative blood results and haematological parameters of patients Early postoperative blood results and haematological parameters Patients with delirium, group 1 (n = 187) Patients without delirium, group 2 (n = 590) p-value Postoperative first day haemoglobin (mg/dl) 9.2 ± 1.1 (median: 9.0, range: 7.4–12.1) 9.1 ± 1.1 (median: 8.9, range: 7.4–12.9) 0.52** Postoperative first day C-reactive protein(mg/l) 31.5 ± 7.9 (median: 29.8, range: 20.1–57.1) 26.9 ± 4.1 (median: 26.8, range: 17.2–39.2 0.0001** Postoperative first day lymphocyte counts (×103 cells/µl) 1.45 ± 0.48 (median: 1.4, range: 0.6–3.4) 1.48 ± 0.49 (median: 1.4, range: 0.4–3.6) 0.38** Postoperative first day MPV (fl) 9.5 ± 0.8 (median: 9.5, range:7.8–11.5) 8.9 ± 0.7 (median: 8.8, range: 7.3–11.0) 0.0001** Postoperative first day PLR 163.9 ± 20.7 (median: 165.8, range: 116.3– 199.2) 135.2 ± 14.2 (median: 132.8, range: 03.8–184.7) 0.0001** Postoperative first day NLR 5.1 ± 0.9 (median: 5.1, range: 3.0–7.5) 3.6 ± 0.9 (median: 3.6, range: 1.5–8.2) 0.0001** Postoperative first day ESR (mm/h) 45.7 ± 17.7 (median: 46.5, range: 10–83) 27.2 ± 12.6 (median: 21.8, range: 7–91) 0.0001** PLR: pre-operative platelet-to-lymphocyte ratio; NLR: neutrophil-to-lymphocyte ratio; ESR: erythrocyte sedimentation rate; MPV: mean platelet volume. **Mann–Whitney U-test.
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