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Correlates of Neurocognitive Function of Patients After Off-Pump Coronary Artery Bypass Surgery

• Background Decreases in neurocognitive function have been reported in patients who have undergone off-pump coronary artery bypass surgery; however, few investigators have examined the correlates of the decreases.

• Objectives To explore and determine the correlates of neurocognitive function at the time of discharge from the hospital in patients undergoing off-pump coronary artery bypass surgery.

• Methods Patients undergoing off-pump coronary artery bypass surgery at Abbott Northwestern Hospital, Minneapolis, Minn, were administered tests of neurocognition (cognition and motor function), anxiety, depression, and quality of life preoperatively (within 72 hours of surgery) and postoperatively (at least 72 hours after surgery but before discharge from the hospital).

• Results A total of 54 patients (79.6% men), mean age 64.5 years, completed tests both preoperatively and postoperatively. When baseline function was controlled for, increased age and new-onset atrial fibrillation (F_3,40 = 42.97; P < .001) were associated with decreases in postoperative cognitive function; increased age and anxiety (F_3,35 = 15.83; P < .001) were associated with decreases in postoperative motor function.

• Conclusion Older patients, anxious patients, and patients with new-onset atrial fibrillation are at risk for neurocognitive changes after off-pump coronary artery bypass surgery. Further studies with larger sample sizes should be done to examine interventions to reduce preoperative anxiety in these patients. Interventions to prevent postoperative atrial fibrillation should be explored to determine whether the interventions prevent a decline in neurocognitive function.

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				S. F. Marasco, L. N. Sharwood, and M. J. Abramson No improvement in neurocognitive outcomes after off-pump versus on-pump coronary revascularisation: a meta-analysis Eur. J. Cardiothorac. Surg., June 1, 2008; 33(6): 961 - 970. [Abstract] [Full Text] [PDF]

				S. Al-Ruzzeh and D. O'Regan Assessment of Neurocognitive Outcome After Cardiac Surgery Ann. Thorac. Surg., July 1, 2007; 84(1): 358 - 358. [Full Text] [PDF]