Predictors of cognitive dysfunction after cardiac surgery: a systematic review

Area of Science:

• Cardiology
• Neuroscience
• Gerontology

Background:

• Postoperative cognitive dysfunction (POCD) is a common concern for patients undergoing cardiac surgery.
• Predictors for POCD vary, and specific patient groups experiencing higher risks are not well-defined.

Purpose of the Study:

• To systematically review and identify preoperative and postoperative predictors of cognitive dysfunction in adults following cardiac surgery.

Main Methods:

• A systematic review of eight bibliographic databases was conducted from January 2005 to March 2021.
• Included studies focused on adult patients undergoing open cardiac surgery with validated cognitive function measurements.
• Data from 36 eligible studies, primarily prospective observational, were analyzed.

Main Results:

• A total of 61 significant predictors (45 preoperative, 16 postoperative) were identified.
• Advancing age and lower education level emerged as key predictors of cognitive outcomes.
• Age was the most frequently reported predictor of cognitive dysfunction.

Conclusions:

• While numerous predictors exist, their impact on cognitive outcomes is inconsistently reported.
• Older patients and those with lower educational attainment should be prioritized for interventions.
• Further high-quality research is necessary to better understand POCD predictors due to methodological limitations in current studies.