Postoperative Delirium After Coronary Artery Bypass Grafting in the United States, 2016-2021: Trends, Risk Factors,...

A retrospective observational study using discharge weights and survey-specific analytic methods.

Analysis of the National Inpatient Sample, representing a nationally weighted cohort of U.S. hospitalizations from 2016 to 2021.

Adults aged 18 years or older who underwent isolated coronary artery bypass grafting (CABG) during the study period.

No interventions were applied.

Postoperative delirium (POD) was identified using validated ICD-10 codes. Using regression models, annual trends in POD, factors associated with POD, and the association of POD with mortality, postoperative complications, length of stay, and hospitalization costs were estimated. Among 911,910 CABG hospitalizations, POD occurred in 4.91% of patients, with a significant increase from 2016 to 2021 (odds ratio [OR] = 1.04 per year; p < 0.001). After multivariable adjustment, the strongest associations with POD were pre-existing dementia (adjusted [a]OR = 4.28; p < 0.001), alcohol abuse (aOR = 3.38; p < 0.001), and psychotic disorders (aOR = 2.40; p < 0.001). POD was independently associated with higher mortality (aOR = 1.85; p < 0.001), major complications, four-day longer length of stay (p < 0.001), and $8,565 higher costs (p < 0.001).

POD after CABG is a common and costly complication. This study identifies high-risk patients and modifiable risk factors, emphasizing the need for targeted strategies to reduce the clinical and economic burdens from POD after CABG.