Preexisting depressive symptoms are associated with long-term cognitive decline in patients after cardiac surgery - 13/09/13
, Simone Messerotti Benvenuti, Ph.D. a, Paolo Zanatta, M.D. b, Elvio Polesel, M.D. c, Daniela Palomba, M.D. aAbstract |
Objective |
To examine whether preoperative psychological dysfunctions rather than intraoperative factors may differentially predict short- and long-term postoperative cognitive decline (POCD) in patients after cardiac surgery.
Method |
Forty-two patients completed a psychological evaluation, including the Trail Making Test Part A and B (TMT-A/B), the memory with 10/30-s interference, the phonemic verbal fluency and the Center for Epidemiological Studies of Depression (CES-D) scale for cognitive functions and depressive symptoms, respectively, before surgery, at discharge and at 18-month follow-up.
Results |
Ten (24%) and 11 (26%) patients showed POCD at discharge and at 18-month follow-up, respectively. The duration of cardiopulmonary bypass significantly predicted short-term POCD [odds ratio (OR)=1.04, P<.05], whereas preoperative psychological factors were unrelated to cognitive decline at discharge. Conversely, long-term cognitive decline after cardiac surgery was significantly predicted by preoperative scores in the CES-D (OR=1.26, P<.03) but not by intraoperative variables (all Ps >.23).
Conclusions |
Our findings showed that preexisting depressive symptoms rather than perioperative risk factors are associated with cognitive decline 18 months after cardiac surgery. This study suggests that a preoperative psychological evaluation of depressive symptoms is essential to anticipate which patients are likely to show long-term cognitive decline after cardiac surgery.
Le texte complet de cet article est disponible en PDF.Keywords : Cardiac surgery, Cognition disorders, Depression, Neuropsychology, Outcome assessment
Plan
| ☆ | Competing interest statement: The authors declare that they have no competing interests to report. |
Vol 35 - N° 5
P. 472-479 - septembre 2013 Retour au numéro
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