Postoperative cognitive dysfunction after simultaneous carotid endarterectomy and coronary artery bypass grafting
Authors:
Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation
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Type: Original articles
DOI:
For citation: Maleva O.V., Korotkevich A.A., Kukhareva I.N., Sosnina A.S., Ivanov S.V., Trubnikova O.A., Barbarash O.L. Postoperative cognitive dysfunction after simultaneous carotid endarterectomy and coronary artery bypass grafting. Creative Cardiology. 2023; 17 (1): 114–23 (in Russ.). DOI: 10.24022/1997-3187-2023-17-1-114-123
Received / Accepted: 31.10.2022 / 15.03.2023
Keywords: simultaneous surgery carotid endarterectomy coronary artery bypass grafting postoperative cognitive dysfunction
Abstract
The aim of the study – to conduct cognitive assessment of patients in the late postoperative period after simultaneous carotid endarterectomy and coronary artery bypass grafting.
Material and methods. The study included 26 patients; the mean age was 64.4 ± 7.3 years. Cognitive outcomes in these patients were assessed after simultaneous coronary artery bypass grafting and unilateral carotid endarterectomy. Extended psychometric testing was carried out using the software and hardware complex Status-PF. The cognitive ability indicators were measured upon admission to the hospital, in the early postoperative period – after 7.5 ± 3.8 days, and in the late postoperative period – after 15.6 ± 3.5 months. Postoperative cognitive dysfunction (POCD) was diagnosed in case of a 20% decline in memory, attention and neurodynamics indicators in 20% of completed tests.
Results. In the early postoperative period, the speed of visual-motor response increased by 9.5% (p = 0.02), whereas cognitive performance decreased by 4.7% compared to baseline (p = 0.03). In the late postoperative period, the speed of visual-motor response decreased by 10.5% compared to the early postoperative period (p = 0.02), thus reaching the baseline values. Moreover, compared to baseline, there was a 16% decrease in the number of errors made when performing the visual-motor response test (p = 0.04). The attention indicator increased by 20.9% compared to baseline (p = 0.008). The cognitive performance test revealed the following: a 4.7% decrease in response time (p = 0.009), a 22.9% increase in missed signals (p = 0.03), and a 14.8% decrease (p = 0.05) in the number of errors made compared to baseline.
Conclusion. Early POCD developed in 16 (61.5%) patients. In the late postoperative period, the number of patients with persistent POCD was 12 (60%), of which 7 (35%) patients had early POCD, and 5 (25%) patients developed persistent POCD without showing the signs of the early POCD.
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About Authors
- Olga V. Maleva, Cand. Med. Sci., Senior Researcher, Cardiologist; ORCID
- Aleksey A. Korotkevich, Junior Researcher, Radiologist; ORCID
- Irina N. Kukhareva, Cand. Med. Sci., Senior Researcher, Neurologist; ORCID
- Anastasiya S. Sosnina, Cand. Med. Sci., Researcher; ORCID
- Sergey V. Ivanov, Dr. Med. Sci., Leading Researcher, Cardiovascular Surgeon; ORCID
- Olga A. Trubnikova, Dr. Med. Sci., Head of the Laboratory, Cardiologist; ORCID
- Olga L. Barbarash, Dr. Med. Sci., Professor, Academician of the Russian Academy of Sciences, Director; ORCID