Association of CT perfusion and postoperative cognitive dysfunction after off-pump coronary artery bypass grafting.

OBJECTIVE

To investigate the relationship between an abnormal CT perfusion scan and postoperative cognitive dysfunction, as measured by changes in MoCA and MMSE scores, after off-pump coronary artery bypass grafting (OPCABG).

METHODS

Eight hundred and thirteen patients were selected who underwent OPCABG between August 2010 and September 2013. Cognitive function was assessed before operation and at seven days post-op. CT perfusion scan was obtained preoperatively and was used to divide patients into two groups: abnormal perfusion and normal perfusion groups.

RESULTS

(1) Logistic regression analysis showed that perfusion abnormalities (OR, 3.012; 95% CI, 1.660-5.463; P < 0.05) were an independent risk factor for postoperative cognitive dysfunction (POCD). (2) 556 patients with CT perfusion scans were divided into normal perfusion and abnormal perfusion groups: incidence of POCD in the abnormal perfusion group is significantly higher than the control group (21.6 vs 8.6%, P < 0.05); MMSE scores were significantly lower in patients with abnormal perfusion before and after surgery. MoCA scores demonstrated a significant drop after surgery for all patients with abnormal perfusion (P < 0.05). The abnormal perfusion group had a significant reduction in the visuospatial/executive and naming scores in the MoCA as compared to normal perfusion (P < 0.05).

CONCLUSION

Abnormal CT perfusion is a significant risk factor for postoperative cognitive dysfunction, and has the most impact on visuospatial/executive and naming functions.