[Neuropsychological outcomes after coronary artery bypass grafting].

OBJECTIVE

Neuropsychological (cognitive) dysfunction has been described as an important complication, affecting up to 80% of patients early after cardiac surgery. Also it has been shown that cognitive abnormalities persist in a later postoperative follow up. The aim of our study was to determine incidence of cognitive complications early after isolated coronary artery bypass grafting using cardiopulmonary bypass, and to identify predictive factors, associated with perioperative cerebral dysfunction.

MATERIAL AND METHODS

Eighty-six patients (63 men and 23 women; mean age 66.1+/-6.7 year) with identified isolated coronary artery disease were enrolled into prospective study using Case Report data collection document. Neuropsychological status was examined using Symbol Digit Modalities Test with additional Euro QOL test. All tests were performed at baseline (1 day before operation), at the 5(th) to 7(th) postoperative day and one month after operation.

RESULTS

Neuropsychological dysfunction (as compared with baseline) occurred in 59 patients (68.6%) at the 5(th)-7(th) postoperative day and persisted in 19 patients (22.1%) after one month. Patients who suffered postoperative cerebral dysfunction more often had history of prior cerebrovascular morbidity (p<0.05), poor left ventricular ejection fraction (<or=35%) (p<0.05) and higher incidence of left main coronary artery disease (p<0.05).

CONCLUSIONS

Cognitive dysfunction is still important complication after coronary artery bypass grafting persisting during the early follow-up in some patients. Symbol Digit Modalities Test was sensitive instrument for diagnostics of postoperative neuropsychological complications reasons.