Incidence and risk factors for delirium in cardiac surgery intensive care unit patients: A single-center study

doi:10.5492/wjccm.123279

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World Journal of Critical Care Medicine

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2220-3141

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Crit Care Med. Sep 9, 2026; 15(3): 123279
Published online Sep 9, 2026. doi: 10.5492/wjccm.123279

Incidence and risk factors for delirium in cardiac surgery intensive care unit patients: A single-center study

Fotios Dimitriadis, Christos Kourek, Niki Rouvali, Charalambia Kinti, Mariantzela Mavraki, Magda Georgopoulou, Theodoros Pitsolis, Theodosia Maragkoulia, Kyriaki Kolovou, Giorgos Konstantinou, Theodora Soulele, Michail Zervos, Paraskevi Salata, Dimitrios Elaiopoulos, Dimitra Doubou, Chrysa Panagiotou, Stavros Dimopoulos

Co-first authors: Fotios Dimitriadis and Christos Kourek.

Author contributions: Dimitriadis F, Kourek C, and Dimopoulos S contributed to the study conception and design; Rouvali N, Kinti C, Mavraki M, Georgopoulou M, Pitsolis T, Maragkoulia T, Kolovou K, Konstantinou G, Soulele T, Zervos M, Salata P, Elaiopoulos D, Doubou D, and Panagiotou C contributed to material preparation, data acquisition, and analysis; Dimitriadis F and Kourek C contributed equally to this study and share first authorship; and all authors contributed to manuscript drafting and critical revision and approved the final version for submission.

AI contribution statement: ChatGPT (OpenAI) was used solely for language editing, including proofreading for spelling, grammar, and syntax. The authors reviewed and approved all revisions and remain fully responsible for the content of the manuscript.

Institutional review board statement: This study was approved by the Institutional Review Board and Ethics Committee of the Onassis Cardiac Surgery Center, Athens, Greece, Protocol No. 641/14.03.2019.

Informed consent statement: All study participants, or their legal representatives when appropriate, provided written informed consent prior to study enrollment.

Conflict-of-interest statement: All the authors declare that they have no relevant conflicts of interest related to this article.

CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.

Data sharing statement: The data supporting the findings of this study are available from the corresponding author upon reasonable request, subject to patient confidentiality and institutional regulations.

Corresponding author: Stavros Dimopoulos, MD, PhD, Cardiac Surgery Intensive Care Unit, Onassis Cardiac Surgery Center, 356 Syggrou Av, Athens 17674, Attikí, Greece. s.dimopoulos@onasseio.gr

Received: May 15, 2026
Revised: June 28, 2026
Accepted: July 31, 2026
Published online: September 9, 2026
Processing time: 100 Days and 16.7 Hours

Abstract

BACKGROUND

Delirium is a frequent and serious complication following cardiac surgery, particularly in patients admitted to the intensive care unit (ICU), where it can negatively impact recovery and outcomes.

AIM

To investigate the incidence, risk factors, and clinical consequences of delirium in post-cardiac surgery ICU patients.

METHODS

A total of 202 consecutive patients admitted to the cardiac surgery ICU at the Onassis Cardiac Surgery Center were evaluated for delirium using the Confusion Assessment Method-ICU scale.

RESULTS

Delirium was observed in 29.2% of the cohort and was independently associated with older age, longer total anesthesia/sedation duration, and higher EuroSCORE II. These variables showed poor-to-fair/modest discriminatory ability for delirium prediction. Patients who developed delirium experienced more frequent reintubation, higher rates of ICU-acquired weakness and hemodialysis, prolonged mechanical ventilation, and extended ICU stays.

CONCLUSION

These findings underscore the multifactorial nature of postoperative delirium and suggest that older age, higher EuroSCORE II, and longer anesthesia exposure are associated with increased delirium risk. However, given the exploratory design and modest discriminatory performance of the identified variables, these findings should not be interpreted as a validated risk prediction tool and require confirmation in larger multicenter studies.

Keywords: Delirium; Incidence; Cardiac surgery; Intensive care unit; Risk factors; EuroSCORE II

Core Tip: In this prospective single-center study of 202 patients admitted to a cardiac surgery intensive care unit (ICU), delirium occurred in 29.2% during ICU hospitalization. Older age, longer total anesthesia-sedation duration, and higher EuroSCORE II were independently associated with delirium. Patients with delirium also had higher rates of reintubation, ICU-acquired weakness, and hemodialysis, as well as longer mechanical ventilation and ICU stay. These findings support systematic postoperative delirium surveillance in high-risk cardiac surgical patients, while highlighting the need for larger multicenter studies to refine risk assessment and prevention strategies.