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Association between Perioperative Parameters and Cognitive Impairment in Post-Cardiac Surgery Patients.

Ghaffary S, Hajhossein Talasaz A, Ghaeli P, Karimi A, Salehiomran A, Hajighasemi A, Bina P, Darabi S, Jalali A, Dianatkhah M, Noroozian M, Shahmansouri N - J Tehran Heart Cent (2015)

Bottom Line: In univariate analysis, the baseline WMT score, serum levels of lactate dehydrogenase and T3, cross-clamp time, and preexistence of chronic obstructive pulmonary disease showed significant effects on the postoperative WMT score (p value < 0.05), whereas only the baseline WMT score and chronic obstructive pulmonary disease showed strong effects on the postoperative WMT score in the multiple regression model.Preoperative nitrate administration led to a significant improvement in POCD.It is also concluded that the preoperative administration of specific medicines like nitrates can reduce neurological complications after cardiac surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Pharmacotherapy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.

ABSTRACT

Background: Postoperative cognitive dysfunction (POCD) has been an important complication of cardiac surgery over the years. Neurocognitive dysfunction can affect quality of life and lead to social, functional, emotional, and financial problems in the patient's life. To reduce POCD, we sought to identify the association between cognitive dysfunction and perioperative factors in patients undergoing cardiac surgery.

Methods: One hundred one patients aged between 45 and 75 years undergoing elective cardiac surgery were enrolled in this study. All the surgeries were performed on-pump by the same medical team. A brief Wechsler Memory Test (WMT) was administered before surgery, 3 to 5 days after the surgery, and 3 months after discharge. All related perioperative parameters were collected in order to study the effect of these parameters on the postoperative WMT scores and WMT score change.

Results: The study population consisted of 101 patients, comprising 14 (13.8%) females and 87 (86.2%) males aged between 45 and 75 years. In univariate analysis, the baseline WMT score, serum levels of lactate dehydrogenase and T3, cross-clamp time, and preexistence of chronic obstructive pulmonary disease showed significant effects on the postoperative WMT score (p value < 0.05), whereas only the baseline WMT score and chronic obstructive pulmonary disease showed strong effects on the postoperative WMT score in the multiple regression model. In addition, the multiple regression model demonstrated a significant association between the baseline WMT score, serum creatinine level, and nitrate administration and the WMT score change.

Conclusion: Our study showed that preexisting chronic obstructive pulmonary disease and preoperative high serum creatinine levels negatively affected cognitive function after surgery. In addition, there was a strong relationship between the patients' basic cognition and POCD. Preoperative nitrate administration led to a significant improvement in POCD. It is also concluded that the preoperative administration of specific medicines like nitrates can reduce neurological complications after cardiac surgery.

No MeSH data available.


Related in: MedlinePlus

Association between the baseline Wechsler Memory Test (WMT) score and the postoperative WMT score
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Figure 2: Association between the baseline Wechsler Memory Test (WMT) score and the postoperative WMT score

Mentions: According to the analysis, the baseline WMT score was the strong predictive factor in both regression models. As is seen in Figure 2, there was a high correlation between the baseline and postoperative WMT scores (r = 0.77) (Figure 2).


Association between Perioperative Parameters and Cognitive Impairment in Post-Cardiac Surgery Patients.

Ghaffary S, Hajhossein Talasaz A, Ghaeli P, Karimi A, Salehiomran A, Hajighasemi A, Bina P, Darabi S, Jalali A, Dianatkhah M, Noroozian M, Shahmansouri N - J Tehran Heart Cent (2015)

Association between the baseline Wechsler Memory Test (WMT) score and the postoperative WMT score
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4477092&req=5

Figure 2: Association between the baseline Wechsler Memory Test (WMT) score and the postoperative WMT score
Mentions: According to the analysis, the baseline WMT score was the strong predictive factor in both regression models. As is seen in Figure 2, there was a high correlation between the baseline and postoperative WMT scores (r = 0.77) (Figure 2).

Bottom Line: In univariate analysis, the baseline WMT score, serum levels of lactate dehydrogenase and T3, cross-clamp time, and preexistence of chronic obstructive pulmonary disease showed significant effects on the postoperative WMT score (p value < 0.05), whereas only the baseline WMT score and chronic obstructive pulmonary disease showed strong effects on the postoperative WMT score in the multiple regression model.Preoperative nitrate administration led to a significant improvement in POCD.It is also concluded that the preoperative administration of specific medicines like nitrates can reduce neurological complications after cardiac surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Pharmacotherapy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.

ABSTRACT

Background: Postoperative cognitive dysfunction (POCD) has been an important complication of cardiac surgery over the years. Neurocognitive dysfunction can affect quality of life and lead to social, functional, emotional, and financial problems in the patient's life. To reduce POCD, we sought to identify the association between cognitive dysfunction and perioperative factors in patients undergoing cardiac surgery.

Methods: One hundred one patients aged between 45 and 75 years undergoing elective cardiac surgery were enrolled in this study. All the surgeries were performed on-pump by the same medical team. A brief Wechsler Memory Test (WMT) was administered before surgery, 3 to 5 days after the surgery, and 3 months after discharge. All related perioperative parameters were collected in order to study the effect of these parameters on the postoperative WMT scores and WMT score change.

Results: The study population consisted of 101 patients, comprising 14 (13.8%) females and 87 (86.2%) males aged between 45 and 75 years. In univariate analysis, the baseline WMT score, serum levels of lactate dehydrogenase and T3, cross-clamp time, and preexistence of chronic obstructive pulmonary disease showed significant effects on the postoperative WMT score (p value < 0.05), whereas only the baseline WMT score and chronic obstructive pulmonary disease showed strong effects on the postoperative WMT score in the multiple regression model. In addition, the multiple regression model demonstrated a significant association between the baseline WMT score, serum creatinine level, and nitrate administration and the WMT score change.

Conclusion: Our study showed that preexisting chronic obstructive pulmonary disease and preoperative high serum creatinine levels negatively affected cognitive function after surgery. In addition, there was a strong relationship between the patients' basic cognition and POCD. Preoperative nitrate administration led to a significant improvement in POCD. It is also concluded that the preoperative administration of specific medicines like nitrates can reduce neurological complications after cardiac surgery.

No MeSH data available.


Related in: MedlinePlus