Hyperlipidemia and Postoperative Hallucinations After Cardiac Surgery: Insights from the VAACS Cohort Study

Abu Khadija, H; Abu Hamdeh, N; Najajra, D; Masu'd, M; Dabash, A; Zahran, A; Bali, B; Ewidat, O; Awwad, M; Hamdan, Y; Kharraz, L; Heih, OQ; Ibraheem, K; Hroub, O; AbuSalah, O; Othman, W; Muath Daraghmeh, S; Al-Khdour, I; Alkhatib, H; Rubi, A; Al-Aydi, NN; Nairat, M; Khader, M; Abu Hamda, OIH; Abdul-Hafez, HA; Hamoudy, K; Nana, O; Alnees, M; Darwish, A

doi:10.1053/j.jvca.2025.11.036

Cardiothoracic & vascular anesthesia

Hyperlipidemia and Postoperative Hallucinations After Cardiac Surgery: Insights from the VAACS Cohort Study

J Cardiothorac Vasc AnesthPublished 28 Nov 2025Prospective cohort study

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Authors' conclusion

Elevated LDL/HDL ratio is a significant predictor of postoperative hallucinations.

Study context

Population: Adults (≥18 years) undergoing CABG or valve surgery at ten tertiary cardiac surgery centres, West Bank of Palestine
Participants: 1,332 adults

Exposure: Hyperlipidemic vs normolipidemic patients
Hyperlipidemicn = 448
Normolipidemicn = 884reference
Outcome: Cumulative incidence of postoperative visual and auditory hallucinations (Questionnaire for Psychotic Experiences)
Follow-up: Up to day 7

Methodological detailsmulticentre, Kaplan-Meier estimation, multivariable Cox proportional hazards regression

Multicentre
Kaplan-Meier estimation
Multivariable Cox proportional hazards regression

Main finding

As reported in the abstract

Postoperative hallucinations

Postoperative hallucinations · up to day 7

Hyperlipidemic11.2%

Normolipidemic10.3%

Auditory hallucinations

Hyperlipidemic7.1%

Normolipidemic6.3%

Observational data: associations, not effects.

Further findings

Outcome	aHR	P value
Predictors: LDL/HDL ratioHyperlipidemic vs Normolipidemic · visual hallucinations	1.136	P = 0.016
Predictors: LDL/HDL ratioHyperlipidemic vs Normolipidemic · auditory hallucinations	1.146	P = 0.017
Predictors: LDL/HDL ratioNormolipidemic · visual hallucinations	1.123	P = 0.038
Predictors: LDL/HDL ratioNormolipidemic · auditory hallucinations	1.110	P = 0.047
Other predictorsLonger aortic cross-clamp time · visual hallucinations	1.007	P = 0.015
Other predictorsIntraoperative fentanyl exposure · visual hallucinations	0.435	P = 0.011
Other predictorsIntraoperative fentanyl exposure · auditory hallucinations	0.377	P = 0.023
Other predictorsCritical preoperative state · auditory hallucinations, hyperlipidemic patients	3.904	P = 0.001

Reference

Authors: Abu Khadija H, Abu Hamdeh N, Najajra D, Masu'd M, Dabash A, Zahran A, et al.
All 29 authors
Abu Khadija H, Abu Hamdeh N, Najajra D, Masu'd M, Dabash A, Zahran A, Bali B, Ewidat O, Awwad M, Hamdan Y, Kharraz L, Heih OQ, Ibraheem K, Hroub O, AbuSalah O, Othman W, Muath Daraghmeh S, Al-Khdour I, Alkhatib H, Rubi A, Al-Aydi NN, Nairat M, Khader M, Abu Hamda OIH, Abdul-Hafez HA, Hamoudy K, Nana O, Alnees M, Darwish A
Journal: Journal of Cardiothoracic and Vascular Anesthesia
Published: 28 Nov 2025
DOI: 10.1053/j.jvca.2025.11.036
PubMed: 41507022

Topic: Cardiothoracic & vascular anesthesia
Also indexed: Perioperative medicine & outcomes

Exposure definitions

Hyperlipidemic: according to preoperative lipid profiles
Normolipidemic: according to preoperative lipid profiles

Key notes

Value = visual hallucinations

Original publication

Hyperlipidemia and Postoperative Hallucinations After Cardiac Surgery: Insights from the VAACS Cohort Study. J Cardiothorac Vasc Anesth. Published 28 November 2025. doi:10.1053/j.jvca.2025.11.036

Read the original article ↗

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