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- W1969974407 abstract "Introduction: Cognitive dysfunction occurs in up to 77% of patients after cardiac surgery. Objective measures of memory, attention and concentration, appear most sensitive to change after cardiac surgery. [1] While there appears to be a gradual improvement in the incidence of cognitive performance measured in the first six months after cardiac surgery, many investigators including our own group have shown that a significant number of patients, 7 to 35%, have persistent cognitive impairment six months and beyond. [2] The purpose of our investigation was to determine the pattern and time course of cognitive decline extending five years after CABG surgery and the influence of perioperative decline on long-term dysfunction. Methods: With Institutional Review Board Approval and patient informed consent 313 undergoing primary CABG were enrolled in an assessment of the effect of age on post-operative cognitive decline. A preoperative neurocognitive battery, previously defined, was undertaken preoperatively, predischarge, six weeks and five years postoperatively. Neurocognitive decline after surgery was defined as a 1 SD drop in 20% or more of test administered. Multivariable logistic regression was utilized to determine factors predicting long-term cognitive decline. Results: Figure 1 below demonstrates the incidence of cognitive decline measured at discharge (41.5%), six-weeks (15.6%) and 5 years (31.1%) postoperatively. The results demonstrate a significant incidence of postoperative cognitive decline that appears initially to improve and then worsen. We investigated predictors of of five year cognitive decline in a multivariable logistic model and found that discharge cognitive decline was the most significant predictor of long-term cognitive dysfunction (p=0.004, Table 1).Figure 1Table 1Discussion: Little is more devastating to a patient, the patient's family or those caring for a patient than to have a successful operation that prolongs life, but diminishes the quality of that prolonged life. Nothing is more likely to adversely impact the quality of life than deterioration in a patient's mental status, particularly those higher faculties that we call cognition. Our results confirm long-term persistence of cognitive dysfunction and the importance of prevention of these perioperative deficits. Further investigation into perioperative neuroprotection is required to allow us to reduce the short and long-term consequences of cognitive decline after surgery." @default.
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- W1969974407 date "1999-04-01" @default.
- W1969974407 modified "2023-09-25" @default.
- W1969974407 title "PERIOPERATIVE NEUROCOGNITIVE DECLINE PREDICTS LONG-TERM (5 YEAR) NEUROCOGNITIVE DETERIORATION AFTER CABG" @default.
- W1969974407 doi "https://doi.org/10.1097/00000539-199904001-00093" @default.
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