| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 1999;67:1669-1676
© 1999 The Society of Thoracic Surgeons
a Department of Neurology and Zanvyl Krieger Mind/Brain Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Accepted for publication December 2, 1998.
Address reprint requests to Dr Selnes, Cognitive Neurology, Johns Hopkins Hospital, Meyer 222, 600 North Wolfe St, Baltimore, MD 21287-7222
e-mail: oselnes{at}jhmi.edu
Background. Several studies have investigated predictors of cognitive decline after coronary artery bypass grafting (CABG), but there is little consensus as to which specific factors are predictive of poor cognitive outcomes.
Methods. We evaluated 127 patients undergoing CABG with standardized neuropsychological tests preoperatively, at 1 month and at 1 year. The outcome measure was a continuous variable reflecting change in z-scores for eight cognitive domains over time for individual patients. Univariate analyses were performed to evaluate the association between the demographic, operative, and postoperative factors and the cognitive outcome variables. Factors that were significant were included in a multiple linear regression analysis.
Results. Among the medical history variables, diabetes was associated with change in executive functions and psychomotor speed. Some of the operative variables were associated with short-term changes, but none with the 1-year outcomes. For example, the surgeon’s rating of degree of difficulty in selecting a cross-clamp site was associated with change in attention. Higher mean pump rate during the procedure was associated with improved performance on tests of language. The cognitive domains associated with medical variables were different from those associated with surgical variables, and the associations observed at 1-year were different from those seen at 1-month.
Conclusions. Change in cognition after CABG is associated with both medical and surgical variables. The specifics of these associations depend on the choice of time points after surgery. This suggests that there are multiple etiologies for these changes, with nonspecific effects of anesthesia and prolonged surgery interacting with the more specific effects of the surgical procedure itself.
Related Article
Ann. Thorac. Surg. 1999 67: 1676.
This article has been cited by other articles:
|
|
 |
|
  T. Gerriets, N. Schwarz, G. Sammer, J. Baehr, E. Stolz, M. Kaps, W.-P. Kloevekorn, G. Bachmann, and M. Schonburg Protecting the brain from gaseous and solid micro-emboli during coronary artery bypass grafting: a randomized controlled trial Eur. Heart J., June 18, 2009; (2009) ehp178v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. P. Slater, T. Guarino, J. Stack, K. Vinod, R. T. Bustami, J. M. Brown III, A. L. Rodriguez, C. J. Magovern, T. Zaubler, K. Freundlich, et al. Cerebral Oxygen Desaturation Predicts Cognitive Decline and Longer Hospital Stay After Cardiac Surgery Ann. Thorac. Surg., January 1, 2009; 87(1): 36 - 45. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. S. Savino and A. T. Cheung Cardiac Anesthesia Card. Surg. Adult, January 1, 2008; 3(2008): 281 - 314. [Full Text]
|
|
|
|
 |
|
 M. Boodhwani, F. Rubens, D. Wozny, R. Rodriguez, and H. J. Nathan Effects of sustained mild hypothermia on neurocognitive function after coronary artery bypass surgery: A randomized, double-blind study. J. Thorac. Cardiovasc. Surg., December 1, 2007; 134(6): 1443 - 1452.e1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. A. Selnes and S. L. Zeger Coronary Artery Bypass Grafting Baseline Cognitive Assessment: Essential Not Optional Ann. Thorac. Surg., February 1, 2007; 83(2): 374 - 376. [Full Text] [PDF]
|
|
|
|
 |
|
 G. Dupuis, E. Kennedy, R. Lindquist, F. B. Barton, M. L. Terrin, B. J. Hoogwerf, S. M. Czajkowski, J. A. Herd, and for the Post CABG Biobehavioral Study Investigator Coronary artery bypass graft surgery and cognitive performance. Am. J. Crit. Care., September 1, 2006; 15(5): 471 - 478. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Boodhwani, F. D. Rubens, D. Wozny, R. Rodriguez, A. Alsefaou, P. J. Hendry, and H. J. Nathan Predictors of Early Neurocognitive Deficits in Low-Risk Patients Undergoing On-Pump Coronary Artery Bypass Surgery Circulation, July 4, 2006; 114(1_suppl): I-461 - I-466. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. N. Djaiani Aortic arch atheroma: stroke reduction in cardiac surgical patients. Seminars in Cardiothoracic and Vascular Anesthesia, June 1, 2006; 10(2): 143 - 157. [Abstract] [PDF]
|
|
|
|
 |
|
 V. I. Chernov, N. Yu. Efimova, I. Yu. Efimova, S. D. Akhmedov, and Y. B. Lishmanov Short-term and long-term cognitive function and cerebral perfusion in off-pump and on-pump coronary artery bypass patients Eur. J. Cardiothorac. Surg., January 1, 2006; 29(1): 74 - 81. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Gao, R. Taha, D. Gauvin, L. B. Othmen, Y. Wang, and G. Blaise Postoperative Cognitive Dysfunction After Cardiac Surgery Chest, November 1, 2005; 128(5): 3664 - 3670. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K.-J. Wang, H.-H. Wu, S.-Y. Fang, Y.-R. Yang, and A. C.-C. Tseng Serum S-100 {beta} Protein During Coronary Artery Bypass Graft Surgery With or Without Cardiopulmonary Bypass Ann. Thorac. Surg., October 1, 2005; 80(4): 1371 - 1374. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Baufreton, P. Allain, A. Chevailler, F. Etcharry-Bouyx, J. J. Corbeau, D. Legall, and J. L. de Brux Brain Injury and Neuropsychological Outcome After Coronary Artery Surgery Are Affected by Complement Activation Ann. Thorac. Surg., May 1, 2005; 79(5): 1597 - 1605. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. A Rodriguez, K. A Williams, A. Babaev, F. Rubens, and H. J Nathan Effect of perfusionist technique on cerebral embolization during cardiopulmonary bypass Perfusion, January 1, 2005; 20(1): 3 - 10. [Abstract] [PDF]
|
|
|
|
|
|
S. W Sutton, M. A Duncan, V. A Chase, B. L Hamman, and E. H Cheung Perfusion-assisted beating heart support with a miniature extracorporeal circuit and leukocyte filtration: a 58-year-old patient with severe COPD Perfusion, December 1, 2004; 19(6): 369 - 373. [Abstract] [PDF]
|
|
|
|
 |
|
 D van Dijk, K G M Moons, A M A Keizer, E W L Jansen, R Hijman, J C Diephuis, C Borst, P P T de Jaegere, D E Grobbee, and C J Kalkman Association between early and three month cognitive outcome after off-pump and on-pump coronary bypass surgery Heart, April 1, 2004; 90(4): 431 - 434. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. M. Ho, D. B. Arciniegas, J. Grigsby, M. McCarthy Jr, G. O. McDonald, T. E. Moritz, A. L. Shroyer, G. K. Sethi, W. G. Henderson, M. J. London, et al. Predictors of cognitive decline following coronary artery bypass graft surgery Ann. Thorac. Surg., February 1, 2004; 77(2): 597 - 603. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. W. Hogue Jr, R. Lillie, T. Hershey, S. Birge, A. M. Nassief, B. Thomas, and K. E. Freedland Gender influence on cognitive function after cardiac operation Ann. Thorac. Surg., October 1, 2003; 76(4): 1119 - 1125. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. J. Cook and G. A. Rooke Priorities in Perioperative Geriatrics Anesth. Analg., June 1, 2003; 96(6): 1823 - 1836. [Full Text] [PDF]
|
|
|
|
|
|
O. A. Selnes, M. A. Grega, L. M. Borowicz Jr, R. M. Royall, G. M. McKhann, and W. A. Baumgartner Cognitive changes with coronary artery disease: a prospective study of coronary artery bypass graft patients and nonsurgical controls Ann. Thorac. Surg., May 1, 2003; 75(5): 1377 - 1386. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. E. Charlson and O. W. Isom Care after Coronary-Artery Bypass Surgery N. Engl. J. Med., April 10, 2003; 348(15): 1456 - 1463. [Full Text] [PDF]
|
|
|
|
 |
|
 C. K. Haddock, W. S. C. Poston, and J. E. Taylor Neurocognitive Sequelae Following Coronary Artery Bypass Graft: A Research Agenda for Behavioral Scientists Behav Modif, January 1, 2003; 27(1): 68 - 82. [Abstract] [PDF]
|
|
|
|
|
|
J. S. Savino, T. F. Floyd, and A. T. Cheung Cardiac Anesthesia Card. Surg. Adult, January 1, 2003; 2(2003): 249 - 281. [Full Text]
|
|
|
|
 |
|
 L. Restrepo, R. J. Wityk, M. A. Grega, L. Borowicz Jr, P. B. Barker, M. A. Jacobs, N. J. Beauchamp, A. E. Hillis, and G. M. McKhann Diffusion- and Perfusion-Weighted Magnetic Resonance Imaging of the Brain Before and After Coronary Artery Bypass Grafting Surgery Stroke, December 1, 2002; 33(12): 2909 - 2915. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Bergh, M. Backstrom, H. Jonsson, L. Havinder, and P. Johnsson In the eye of both patient and spouse: memory is poor 1 to 2 years after coronary bypass and angioplasty Ann. Thorac. Surg., September 1, 2002; 74(3): 689 - 693. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.C. de la Torre Alzheimer Disease as a Vascular Disorder: Nosological Evidence Stroke, April 1, 2002; 33(4): 1152 - 1162. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Kilo, M. Czerny, M. Gorlitzer, D. Zimpfer, H. Baumer, E. Wolner, and M. Grimm Cardiopulmonary bypass affects cognitive brain function after coronary artery bypass grafting Ann. Thorac. Surg., December 1, 2001; 72(6): 1926 - 1932. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. F. Newman, H. P. Grocott, J. P. Mathew, W. D. White, K. Landolfo, J. G. Reves, D. T. Laskowitz, D. B. Mark, J. A. Blumenthal, and J. M. Swearer Report of the Substudy Assessing the Impact of Neurocognitive Function on Quality of Life 5 Years After Cardiac Surgery Editorial Comment Stroke, December 1, 2001; 32(12): 2874 - 2881. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. A. Robson, R. P. Alston, I. J. Deary, P. J. D. Andrews, and M. J. Souter Jugular Bulb Oxyhemoglobin Desaturation, S100{beta}, and Neurologic and Cognitive Outcomes After Coronary Artery Surgery Anesth. Analg., October 1, 2001; 93(4): 839 - 845. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. A. Selnes, R. M. Royall, M. A. Grega, L. M. Borowicz Jr, S. Quaskey, and G. M. McKhann Cognitive Changes 5 Years After Coronary Artery Bypass Grafting: Is There Evidence of Late Decline? Arch Neurol, April 1, 2001; 58(4): 598 - 604. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. A. Selnes and G. M. McKhann Coronary-Artery Bypass Surgery and the Brain N. Engl. J. Med., February 8, 2001; 344(6): 451 - 452. [Full Text] [PDF]
|
|
|
|
|
|
S. Wan and A. P. C. Yim Is Off-Pump Cardiac Surgery Better for the Brain? Chest, January 1, 2001; 119(1): 1 - 1. [Full Text] [PDF]
|
|
|
|
|
|
M. J. A. Robson, R. P. Alston, I. J. Deary, P. J. D. Andrews, M. J. Souter, and S. Yates Cognition After Coronary Artery Surgery Is Not Related to Postoperative Jugular Bulb Oxyhemoglobin Desaturation Anesth. Analg., December 1, 2000; 91(6): 1317 - 1326. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. van Dijk, A. M. A. Keizer, J. C. Diephuis, C. Durand, L. J. Vos, and R. Hijman Neurocognitive dysfunction after coronary artery bypass surgery: A systematic review J. Thorac. Cardiovasc. Surg., October 1, 2000; 120(4): 632 - 639. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
