Thirty-six patients who underwent open heart surgery were given preoperative psychiatric evaluations to determine whether postoperative expressions of delirium might be related to preexisting but covert psychiatric illness. Findings included a poor postoperative prognosis for patients with preoperative organic brain syndrome and a relatively high incidence of postcardiotomy delirium among those who had preoperative psychiatric symptoms. The authors suggest the use of more refined projective techniques to detect minimal organic impairment that might carry an increased risk of postoperative morbidity and mortality. Also, with more definitive parameters for determining preoperative psychiatric difficulties, they conclude, the predictability of postcardiotomy delirium may be enhanced.
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