{Reference Type}: Journal Article
{Title}: Assessment of long-term cognitive dysfunction in older patients who undergo heart surgery.
{Author}: Florido-Santiago M;Pérez-Belmonte LM;Osuna-Sánchez J;Barbancho MA;Ricci M;Millán-Gómez M;Bernal-López MR;Gómez-Huelgas R;Lara JP;
{Journal}: Neurologia (Engl Ed)
{Volume}: 38
{Issue}: 6
{Year}: 2023 Jul-Aug
暂无{DOI}: 10.1016/j.nrleng.2020.12.005
{Abstract}: <B>BACKGROUND: </B>Older patients are more likely to have cognitive dysfunction, and a great proportion of patients undergone surgical procedures are older adults. Postoperative cognitive dysfunction (POCD) has been shown as a consistent complication after major surgical procedures such as heart surgery.<BR><B>OBJECTIVE: </B>To determine the presence of long-term POCD in ≥65-year-old patients undergoing coronary artery bypass grafting and aortic valve replacement, and to establish related risk factors.<BR><B>METHODS: </B>We prospectively and sequentially included 44 patients with coronary disease and aortic stenosis scheduled for heart surgery. Follow-up of all patients was standardized and a neurocognitive evaluation were performed preoperatively and at 1, 6 and 12 months after surgery.<BR><B>RESULTS: </B>Patients experienced a significantly postoperative cognitive dysfunction (33.5%, 63.4% and 38.9% at 1, 6 and 12 months, respectively) from baseline (20.5%). Patient-associated aspects such as age (p<0.01), history of smoking (p<0.01), arterial hypertension (p=0.022), diabetes mellitus (p=0.024), heart failure (p=0.036) and preoperative cognitive dysfunction (p<0.01), and surgery-associated aspects such as EuroSCORE (p<0.01) and operation time (p<0.01) were identified as related risk factors.<BR><B>CONCLUSIONS: </B>Older patients who underwent heart surgery had long-term POCD. Both patient- and surgery-related risk factors were established as related risk factors. These findings suggest that the prevalence of cognitive dysfunction after cardiac surgery in older patients could be related to a possible progression to dementia. In addition, many of the risk factors identified may be modifiable but in practice, these patients are not attended to for their possible cognitive impairment.