期刊
GENERAL HOSPITAL PSYCHIATRY
卷 35, 期 5, 页码 472-479出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.genhosppsych.2013.05.004
关键词
Cardiac surgery; Cognition disorders; Depression; Neuropsychology; Outcome assessment
类别
资金
- European Social Fund [2105/101/1/722/2009]
- Motta di Livenza Hospital, Treviso
Objective: To examine whether preoperative psychological dysfunctions rather than intraoperative factors may differentially predict short- and long-term postoperative cognitive decline (POCD) in patients after cardiac surgery. Method: Forty-two patients completed a psychological evaluation, including the Trail Making Test Part A and B (TMT-A/B), the memory with 10/30-s interference, the phonemic verbal fluency and the Center for Epidemiological Studies of Depression (CES-D) scale for cognitive functions and depressive symptoms, respectively, before surgery, at discharge and at 18-month follow-up. Results: Ten (24%) and 11 (26%) patients showed POCD at discharge and at 18-month follow-up, respectively. The duration of cardiopulmonary bypass significantly predicted short-term POCD [odds ratio (OR)=1.04, P<05], whereas preoperative psychological factors were unrelated to cognitive decline at discharge. Conversely, long-term cognitive decline after cardiac surgery was significantly predicted by preoperative scores in the CES-D (OR=1.26, P<.03) but not by intraoperative variables (all Ps>.23). Conclusions: Our findings showed that preexisting depressive symptoms rather than perioperative risk factors are associated with cognitive decline 18 months after cardiac surgery. This study suggests that a preoperative psychological evaluation of depressive symptoms is essential to anticipate which patients are likely to show long-term cognitive decline after cardiac surgery. (C) 2013 Elsevier Inc. All rights reserved.
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