Abstract

Background

Hallucinations are underrecognized neuropsychiatric complications after cardiac surgery. Data on incidence and type-specific predictors in coronary artery bypass grafting (CABG) and valvular surgery are limited.

Methods

We conducted a multicenter prospective cohort study (September 2022 to May 2025) across West Bank cardiac surgery centers. A total of 1332 adults (997 CABG, 335 valve) were assessed daily for 7 days postoperatively using the Questionnaire for Psychotic Experiences. Predictors of visual and auditory hallucinations evaluated with Cox proportional hazards models.

Results

Visual hallucinations occurred in 11.5 % of CABG patients and 10.0 % of valve surgery patients, while auditory hallucinations were reported in 7.0 % and 5.0 %, respectively. In the CABG group, the multivariable Cox regression models stratified by hospital showed that auditory hallucinations were significantly associated with lower left ventricular ejection fraction (HR = 1.05 per 1 % decrease; 95 % CI 1.01–1.09), longer aortic cross-clamp time (HR = 1.01 per minute; 95 % CI1.0004–1.02), and immunosuppressive therapy (HR = 4.81; 95 % CI 1.13–20.53). Postoperative blood transfusion was associated with an increased risk of visual hallucinations in univariate analysis (HR = 1.87; 95 % CI 1.05–3.33), but the association became borderline after adjustment (HR = 1.97; 95 % CI 0.95–4.09). Among the valve surgery cohort, the hospital-stratified models indicated that prolonged postoperative ventilation was independently protective against visual hallucinations (adjusted HR = 0.78; 95 % CI 0.68–0.90), whereas noradrenalin use (adjusted HR = 6.07; 95 % CI 2.18–16.93) and immunosuppressive therapy (adjusted HR = 5.13; 95 % CI 1.14–23.09) markedly increased the risk. For auditory hallucinations in valve surgery patients, adrenaline exposure emerged as a significant independent predictor (adjusted HR = 3.40; 95 % CI 1.21–9.54.

Conclusions

Postoperative hallucinations affected ~1 in 10 patients; visual hallucinations were more frequent, auditory hallucinations linked to stress and medications, with risks varying by surgery type, supporting tailored monitoring and prevention.

العنوان

Journal of Psychosomatic Research

الناشر

Mohammad alnees

بلد الناشر

فلسطين

Indexing

Scopus

معامل التأثير

None

نوع المنشور

إلكتروني فقط

المجلد

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السنة

--

الصفحات

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