Effect of preoperative cognitive dysfunction on postoperative outcomes in cardiac surgery

Authors

  • Anantachote Vimuktanandana Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
  • Wirinda Chiravanich Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
  • Pakorn Urusopone Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
  • Pongpol Sirilaksanamanon Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
  • Toonchai Indrambarya Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand

Keywords:

Preoperative cognitive dysfunction, cardiac surgery, postoperative outcome, cognitive assessment

Abstract

Background: Preoperative cognitive dysfunction (PreOCD) has not been well described as a risk factor for poor outcomes in cardiac surgery. This study was aimed to demonstrate the effects of PreOCD on postoperative outcomes in cardiac surgery.

Methods: One hundred adult patients undergoing elective open cardiac surgery at King Chulalongkorn Memorial Hospital were recruited. The Montreal Cognitive Assessment (MoCA) was used to evaluate cognitive function the evening before surgery and defined a score of less than 26 as cognitive impairment. We compared postoperative outcome data between patients with PreOCD group and no PreOCD group.

Results: One patient in the PreOCD group withdrew from our study. Sixty nine out of 99 patients (68.31%) had PreOCD. In the PreOCD group, the postoperative mechanical ventilation period was significantly longer (15.9 gif.latex?\pm 26.6 vs. 7.4 gif.latex?\pm 8.76 hours, P = 0.018), ICU stay was significantly longer (39.9 gif.latex?\pm 43.7 vs. 27.6 gif.latex?\pm 15.0 hours, P = 0.039), and the cost of hospital stay was significantly higher (13,540 gif.latex?\pm 6,355 vs. 11,264 gif.latex?\pm 5,229 baht, P = 0.014). However, the length of hospital stay was not significantly different (10.1 gif.latex?\pm 3.8 vs. 9.3 gif.latex?\pm 4.4 days, P = 0.384).

Conclusions: We demonstrated the adverse effects of PreOCD on patients outcomes after cardiac surgery. Identifying PreOCD may be useful in risk stratification during preoperative assessment to improve surgical outcomes.

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Published

2023-08-04

How to Cite

1.
Vimuktanandana A, Chiravanich W, Urusopone P, Sirilaksanamanon P, Indrambarya T. Effect of preoperative cognitive dysfunction on postoperative outcomes in cardiac surgery. Chula Med J [Internet]. 2023 Aug. 4 [cited 2024 Nov. 22];63(1). Available from: https://he05.tci-thaijo.org/index.php/CMJ/article/view/269

Issue

Vol. 63 No. 1 (2019): Chulalongkorn Medical Journal

Section

Original Articles

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