Structured Abstract

Objective

To evaluate the cumulative incidence and predictors of postoperative visual and auditory hallucinations among hyperlipidemic and normolipidemic patients undergoing cardiac surgery, with particular focus on lipid indices, especially the LDL/HDL ratio.

Design

Multicenter, prospective cohort study with daily postoperative assessments from days 1–4 and follow-up to day 7, employing Kaplan–Meier estimation and multivariable Cox proportional hazards regression.

Setting

Ten tertiary cardiac surgery centers across the West Bank of Palestine.

Participants

Adults (≥18 years) undergoing coronary artery bypass grafting (CABG) or valve surgery (N = 1,332), stratified as hyperlipidemic (n = 448) or normolipidemic (n = 884) according to preoperative lipid profiles. Patients with incomplete records, cognitive impairment, language barriers, or psychiatric illness were excluded.

Interventions

None (observational study).

Measurements and Main Results

Postoperative hallucinations were assessed using the validated Questionnaire for Psychotic Experiences (QPE). By day 7, visual hallucinations occurred in 11.2% of hyperlipidemic and 10.3% of normolipidemic patients, while auditory hallucinations occurred in 7.1% and 6.3%, respectively. The LDL/HDL ratio independently predicted both visual and auditory hallucinations in hyperlipidemic (visual: aHR 1.136, p = 0.016; auditory: aHR 1.146, p = 0.017) and normolipidemic (visual: aHR 1.123, p = 0.038; auditory: aHR 1.110, p = 0.047) cohorts. Longer aortic cross-clamp time increased visual hallucination risk (aHR 1.007; p = 0.015), while intraoperative fentanyl exposure reduced both visual (aHR 0.435; p = 0.011) and auditory (aHR 0.377; p = 0.023) hallucinations. A critical preoperative state predicted auditory hallucinations in hyperlipidemic patients (aHR 3.904; p = 0.001).

Conclusions

Elevated LDL/HDL ratio is a significant predictor of postoperative hallucinations. Integrating lipid profile evaluation into perioperative risk assessment may enhance neuropsychiatric outcomes following cardiac surgery.

العنوان

Journal of Cardiothoracic and Vascular Anesthesia

الناشر

Nizar Abu Hamdeh

بلد الناشر

فلسطين

Indexing

Scopus

معامل التأثير

None

نوع المنشور

إلكتروني فقط

المجلد

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السنة

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الصفحات

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