600 Section - Association Between Cognitive Impairment in ICU and Oral Intake Status at Hospital Discharge After Cardiovascular Surgery

Wednesday, May 20, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

IT

Ippei Tamura, MD

Doctor
Hirosaki University Hospital, Department of Rehabilitation Medicine
Hirosaki, Aomori, Japan

Co-Author(s)

AF

Ayaka Fujita, PhD

Assistant Professor
Hirosaki University Hospital, Department of Rehabilitation Medicine
Hirosaki, Aomori, Japan
NM

Naoya Matsuda, PhD

Assistant Professor
Hirosaki University Hospital, Department of Rehabilitation Medicine
Hirosaki, Aomori, Japan
EH

Eiji Hashiba, PhD

Associate Professor
Hirosaki University Hospital, Department of Intensive Care
Hirosaki, Aomori, Japan
ET

Eiichi Tsuda, PhD

Professor
Hirosaki University Graduate School of Medicine, Department of Rehabilitation Medicine
Hirosaki, Aomori, Japan

Objectives : Postoperative cognitive impairment frequently develops during intensive care unit (ICU) stay after cardiovascular surgery and may interfere with early mobilization and rehabilitation, potentially leading to feeding and swallowing disorder (FSD). However, the association between postoperative cognitive impairment in the ICU and oral intake status at hospital discharge remains unclear. This study aimed to investigate whether cognitive impairment during ICU stay was associated with oral intake status at hospital discharge in patients undergoing cardiovascular surgery.

Design: This retrospective cohort study included 594 patients admitted to the ICU after cardiovascular surgery between September 2021 and August 2025. Cognitive impairment was defined as the highest Intensive Care Delirium Screening Checklist (ICDSC) score of 3 or higher within 7 days after ICU admission. Oral intake status at discharge was assessed using the Functional Oral Intake Scale (FOIS), and FOIS levels 1 to 3 were defined as FSD. The association between cognitive impairment and FSD was analyzed using Fisher’s exact test. Multivariable logistic regression analysis was performed to adjust for disease severity using the Acute Physiology and Chronic Health Evaluation II (APACHE II) score.

Results: Cognitive impairment during ICU stay was observed in 90 patients (15.2%), and FSD at hospital discharge occurred in 11 of these patients (12.2%), showing a significantly higher incidence of FSD compared with 5 of 504 patients (1.0%) without cognitive impairment (p < 0.001). Patients with cognitive impairment had a higher risk of FSD at discharge (risk ratio 12.3; 95% confidence interval [CI], 4.4–34.6). After adjustment for APACHE II score, cognitive impairment remained independently associated with FSD at discharge (adjusted odds ratio 12.8; 95% CI, 4.5–41.7; p < 0.001).

Conclusion: Cognitive impairment during ICU stay after cardiovascular surgery was independently associated with impaired oral intake at hospital discharge. Early identification and rehabilitation interventions targeting cognitive impairment may contribute to prevention of prolonged FSD.