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American Journal of Critical Care. 2006;15: 471-478
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CE Article

Coronary Artery Bypass Graft Surgery and Cognitive Performance

By Gilles Dupuis, PhD, Elaine Kennedy, MSc, Ruth Lindquist, PhD, Franca B. Barton, MS (Hyg), Michael L. Terrin, MD, Byron J. Hoogwerf, MD, Susan M. Czajkowski, PhD, J. Alan Herd, MD for the Post CABG Biobehavioral Study Investigators.. From the Department of Psychosomatic Medicine, Montreal Heart Institute, Montreal, Quebec (GD), Department of Psychology, University of Quebec at Montreal, Montreal, Quebec (GD, EK), University of Minnesota School of Nursing, Minneapolis, Minn (RL), Maryland Medical Research Institute, Baltimore, Md (FBB, now with EMMES Corp, Potomac, Md; MLT, now with University of Maryland, Baltimore), Cleveland Clinic Foundation, Cleveland, Ohio (BJH), National Heart, Lung, and Blood Institute, Bethesda, Md (SMC), and Baylor College of Medicine, Houston, Tex (JAH).

Corresponding author: Gilles Dupuis, PhD, Department of Psychosomatic Medicine, Montreal Heart Institute, 5000 Belanger St E, Montreal, Quebec H1T 1C8, Canada (e-mail: dupuis.gilles{at}uqam.ca).

• Background Some studies have indicated a decline in patients’ cognitive performance after coronary artery bypass graft surgery.

• Objective To evaluate cognitive performance before and after coronary artery bypass graft surgery.

• Methods Patients’ cognitive performance before and after coronary artery bypass graft surgery was evaluated in a prospective observational multicenter study in 5 academic medical centers. A total of 242 men and 123 women were evaluated before surgery; 333 men and 216 women, 5 to 11 months after surgery (197 men and 99 women were evaluated both before and after surgery). Verbal ability, attention/concentration, logical/verbal and visual memory, and facial recognition were measured. Data on demographic, medical, and psychosocial characteristics also were collected.

• Results After surgery, patients’ overall performance improved (P < .001) for attention/concentration, verbal fluency, and logical/verbal memory. Patients with more education (high school or greater) performed better on each test (P < .001) than did patients with less education. No strong effects of sex or age on cognitive performance were observed before or after surgery, and no important differences in sex, age, or education were associated with changes in scores from before to after surgery.

• Conclusion On average, cognitive performance improved rather than declined after coronary artery bypass graft surgery. The improvements were consistent across sex, age, and education.

Notice to CE enrollees:
A closed-book, multiple-choice examination following this article tests your understanding of the following objectives:
  1. Discuss the prevalence and etiology of cognitive deficits following coronary artery bypass surgery
  2. Describe the two groups of patients used in this study of coronary artery bypass surgery patients
  3. Discuss the implications for practice






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