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Predictors of early postoperative cognitive dysfunction in middle-aged patients undergoing cardiac surgery: retrospective observational study

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Abstract

Purpose

This study aimed to identify the incidence and risk factors of early post-operative cognitive dysfunction (POCD) in middle-aged patients undergoing cardiac surgery.

Methods

Data were examined retrospectively from 71 patients aged 46–64 years who underwent elective cardiac surgery. Magnetic resonance imaging (MRI) and MR angiography were obtained preoperatively to assess prior cerebral infarctions, carotid artery stenosis, and intracranial arterial stenosis. Patients also completed six neuropsychological tests of memory, attention, and executive function before and after surgery. Mild cognitive impairment (MCI) was defined as performance 1.5 standard deviations (SD) below the population means on any neurocognitive battery, whereas POCD was defined as a decrease of 1 SD population means on at least two in the test battery. Patient characteristics were analyzed using univariate analysis, and independent predictors were analyzed using multivariate logistic regression analysis.

Results

After surgery, 25 patients (35%) were assessed with POCD. Patients with POCD had significantly higher rates of preoperative MCI and cerebral infarcts on MRI. Multivariate logistic regression analysis identified preoperative MCI and cerebral infarctions detected by MRI as a predictor of POCD.

Conclusion

More than one-third of middle-aged patients undergoing cardiac surgery developed POCD. Our findings suggested preoperative MCI and infarcts detected by MRI were risk factors for POCD in these middle-aged patients.

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Data Availability

The data that support the fndings of this report are available from the corresponding author, N.H., upon reasonable request.

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Acknowledgements

The authors would like to thank Dr. Tatsuo Yamamoto for the valuable comments and suggestions.

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Authors and Affiliations

  1. Departments of Anesthesiology, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, Minami-ku, Kumamoto, 862-0965, Japan

    Takafumi Oyoshi, Kengo Maekawa & Yuki Mitsuta

  2. Department of Anesthesiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan

    Takafumi Oyoshi, Yuki Mitsuta & Naoyuki Hirata

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  1. Takafumi Oyoshi
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  2. Kengo Maekawa
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  3. Yuki Mitsuta
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Contributions

TO and KM contributed to the study conception and design. TO, KM, and YM conducted the study, data collection, and analysis. The first draft of the manuscript was written by TO and it was revised by KM and NH. All authors read and approved the final manuscript.

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Correspondence to Naoyuki Hirata.

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Oyoshi, T., Maekawa, K., Mitsuta, Y. et al. Predictors of early postoperative cognitive dysfunction in middle-aged patients undergoing cardiac surgery: retrospective observational study. J Anesth 37, 357–363 (2023). https://doi.org/10.1007/s00540-023-03164-w

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  • DOI: https://doi.org/10.1007/s00540-023-03164-w

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