Neurocognitive dysfunctions in the remote postoperative period during cardiac surgery with artificial blood circulation
The aim - determine the state of cognitive function in the early and late postoperative period in patients with coronary heart disease who underwent on-pump coronary artery bypass grafting. Маterial and methods. In a retrospective observational one-center study, the data obtained from the clinical and instrumental examination of patients who underwent on-pump coronary artery bypass grafting were analyzed. The analysis group included 84 patients (51.5 %) from the total cohort of 163 patients (68 men (80.9 %) and 16 women (19.1 %), mean age 64.4±7.5 years), in which in the early postoperative period cognitive impairments were detected. Neurocognitive testing was performed 3 days prior to surgery, on the 7th day after the intervention, and 3 months after discharge from the hospital using the MMSE Mini Mental State Examination Scale and the Trial Making Test Part A and B. Results. Patients in the surveillance group in the preoperative period at the time of passing the MMSE test scored 26.2±2.3 points. At 7 days after surgery, patients gained 23.6±2.2 points (8.2 % less than before the operation - mild cognitive impairment). 3 months after discharge from the hospital, the patients of the study group gained 24.8±2.2 points (improving the cognitive status, but failed to achieve the upward level of testing). The patients spent 32.0±5.0 seconds test for the Trial Making Test Part A series in the preoperative period and 35.6±6.8 seconds on day 7. After 3 months after the operation, the test results amounted 33.3±5.0 seconds, which didn't differ compared to preoperative indicators. The second part of the Trial Making Test Part B showed similar results. Conclusion. The results of the cognitive tests for patients undergoing coronary artery bypass grafting demonstrated that cognitive dysfunctions registered in the early postoperative period in 51.5 % of patients (in the form of mild cognitive impairment), significantly decreased to 16.6 % at 3 months after surgery, which is consistent with the results of international studies.