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Neurocognitive dysfunction after coronary artery bypass surgery: a systematic review.
D van Dijk1, A M Keizer, J C Diephuis
1Department of Anesthesiology, Utrecht University Hospital, Utrecht, The Netherlands. d.vandijk@anest.azu.nl
The Journal of Thoracic and Cardiovascular Surgery
|September 26, 2000
Summary
Coronary artery bypass grafting frequently leads to neurocognitive dysfunction. Approximately 22.5% of patients experience cognitive deficits two months post-operation, highlighting the need for further research into the causes.
Area of Science:
- Cardiology
- Neurology
- Cognitive Science
Background:
- Evidence suggests coronary artery bypass grafting (CABG) may impair cognitive function.
- Existing studies report varied incidence of cognitive decline due to differing methodologies.
- A systematic review is needed for comparable, quality-assured studies.
Purpose of the Study:
- To systematically review comparable studies on cognitive decline after CABG.
- To establish a more reliable estimate of cognitive impairment incidence.
- To assess neurocognitive outcomes following cardiac surgery.
Main Methods:
- Systematic literature search of four electronic databases and reference lists.
- Inclusion of 23 studies meeting stringent quality criteria based on consensus guidelines.
- Evaluation of 12 cohort and 11 intervention studies.
Main Results:
- Pooled analysis of six comparable studies revealed a 22.5% incidence of cognitive deficit.
- Cognitive deficit was defined as a decrease of at least 1 standard deviation in multiple tests.
- Deficits were observed at two months post-coronary artery bypass surgery.
Conclusions:
- Neurocognitive dysfunction is a common complication of coronary artery bypass grafting.
- The role of cardiopulmonary bypass in this complication requires further investigation.
- A randomized trial comparing on-pump and off-pump surgery is necessary to clarify etiology.