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Risk Factors Associated with Cognitive Decline after Cardiac Surgery: A Systematic Review
Nikil Patel1, Jatinder S Minhas2, Emma M L Chung3
1Department of Cardiovascular Sciences, University of Leicester, Leicester LE2 7LX, UK ; Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester LE3 9QP, UK.
Cardiovascular Psychiatry and Neurology
|October 23, 2015
Summary
Postoperative cognitive decline (POCD) after cardiac surgery is common. This review examines patient and perioperative risk factors contributing to POCD, moving beyond cardiopulmonary bypass as the sole cause.
Area of Science:
- Cardiology
- Neurology
- Surgical Outcomes
Background:
- Cardiac surgery has advanced significantly since the 1950s with cardiopulmonary bypass (CPB).
- Neurological complications, including ischemic stroke, delirium, and cognitive impairment, remain common despite technological improvements.
- Postoperative cognitive decline (POCD) is a significant concern, often linked to cerebral emboli during surgery.
Purpose of the Study:
- To systematically review literature on patient and perioperative risk factors for POCD after cardiac surgery.
- To elucidate the mechanisms contributing to early and late POCD.
- To understand the magnitude of risk factors associated with POCD.
Main Methods:
- Systematic literature review.
- Analysis of studies investigating patient-related risk factors.
- Analysis of studies investigating perioperative risk factors.
Main Results:
- Contradictory results exist regarding CPB as the sole cause of POCD compared to off-pump surgery.
- Growing evidence suggests perioperative and patient-related factors significantly influence POCD.
- Identifying specific mechanisms for POCD remains challenging.
Conclusions:
- POCD after cardiac surgery is multifactorial.
- Patient and perioperative factors are crucial in understanding and potentially mitigating POCD.
- Further research is needed to fully understand and address the complex mechanisms of POCD.
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