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Neurobehavioral outcomes in cardiac operations. A prospective controlled study
B D Townes1, G Bashein, T F Hornbein
1Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle 98195.
The Journal of Thoracic and Cardiovascular Surgery
|November 1, 1989
Summary
Cardiac surgery patients often experience temporary brain dysfunction, but most fully recover within seven months. Advanced age is the only predictor of negative neurobehavioral outcomes after these operations.
Area of Science:
- Neurology
- Cardiology
- Neuropsychology
Background:
- Cardiac operations, including coronary artery bypass grafting and intracardiac procedures, carry a risk of neurological complications.
- Assessing the extent and persistence of cognitive dysfunction post-cardiac surgery is crucial for patient management.
Purpose of the Study:
- To evaluate the severity and duration of organic brain dysfunction following cardiac operations.
- To identify predictors of neurobehavioral outcomes after surgery.
Main Methods:
- A comprehensive neuropsychological test battery was administered to 90 patients undergoing cardiac operations (65 coronary artery bypass grafting, 25 intracardiac) and 47 non-surgical controls.
- Testing occurred preoperatively, before hospital discharge, and approximately seven months postoperatively.
Main Results:
- Surgical patients exhibited generalized neuropsychological impairment near hospital discharge compared to controls.
- No overall residual impairment was observed at seven-month follow-up; surgical patients showed greater improvement than controls.
- A small subset of patients (11%) experienced performance decline, with advanced age identified as the sole predictor of negative outcomes.
Conclusions:
- Neurobehavioral impairment is common post-cardiac surgery but typically resolves favorably.
- The prognosis for full recovery is generally good, though the elderly may have a less favorable outcome.