Disturbed circadian motor activity patterns in postcardiotomy delirium

Area of Science:

• Geriatric Medicine
• Cardiology
• Neurology

Background:

• Postcardiac surgery delirium affects over 20% of elderly patients.
• Delirium is often associated with disrupted 24-hour motor activity, but data are limited.
• Quantifying motor activity is crucial for understanding delirium in this population.

Purpose of the Study:

• To quantify and compare 24-hour motor activity patterns in elderly patients with and without postcardiotomy delirium.
• To assess the relationship between motor activity metrics and delirium severity/duration.

Main Methods:

• Utilized wrist-actigraphy to objectively measure motor activity over 5 days post-cardiac surgery in 79 elderly patients (≥65 years).
• Daily clinical assessment using the Confusion Assessment Method-Intensive Care Unit and Delirium Rating Scale-Revised 98.
• Analyzed specific motor activity parameters including amplitude, activity/minute, restlessness, and immobility.

Main Results:

• Patients without delirium or with short delirium episodes exhibited higher daytime activity amplitude, activity/minute, and restlessness index.
• Conversely, these patients had significantly lower daytime immobility minutes compared to those with sustained delirium (>3 days).

Conclusions:

• Wrist-actigraphy is a valuable tool for objectively evaluating motor activity patterns in patients with postcardiotomy delirium.
• Quantitative motor activity data can aid in the clinical assessment and understanding of delirium post-cardiac surgery.