PubMed2005
OBJECTIVE: The aim of this study was the evaluation of perioperative cognitive dysfunction in patients undergoing cardiovascular surgery with or without cardiopulmonary bypass (CPB) and identification of the risk factors. SUBJECTS AND METHODS: Between July 2001 and October 2003, we performed cognitive examinations in 192 patients (mean age 65.5 +/- 7.6 years) who underwent elective cardiovascular surgery with or without CPB. The cognitive examinations (Hasegawa dementia scale) were done both pre- and postoperatively. Forty-six patients who had developed cognitive dysfunction postoperatively were included in Group A. The remaining 146 patients were placed in the control group (Group B). RESULTS: The patients in Group A were noted to be significantly older than those in Group B (69.8 +/- 7.4 vs. 64.1 +/- 7.2, p < 0.05). The number of patients who at risk for cerebrovascular disease was significantly higher in Group A than in Group B (p < 0.05). Among intraoperative variables, there were no significant differences between the two groups concerning the presence or absence of CPB, CPB duration, and operation duration. The length of postoperative hospitalization of the Group A patients was greater. Age was identified as the only predictor of postoperative cognitive dysfunction in multivariate analysis. CONCLUSION: In the present study, it is possible that CPB did not play a significant role in the genesis of cognitive dysfunction after cardiovascular surgery. Age appears to be the only significant predictor of postoperative cognitive dysfunction.