Assessment of Long-Term Mild and Major Neurocognitive Disorders 48 Months After Cardiac Surgery

To assess the incidence of both Mild and Major Neurocognitive Disorders (NCD), according to the DSM-5 criteria, after cardiac surgery (off-pump an on-pump procedures) and to propose some risk associated factors.

Prospective and sequential study. Patients (n = 70, 65.9 years old, mean age) were evaluated for cognitive function (Neuronorma Battery) and daily life activities (Barthel Index and Bayer-Activities of Daily Living Scale) before surgery and at 1, 6, 12, and 48 months postoperatively. Off-pump (n = 36) and on-pump (n = 34) patients groups were compared. DSM-5 criteria for Mild NCD and Major NCD were applied. Independent associated risk factors were described.

A 40.8% (off-pump) and 39.3% (on-pump) of patients met DSM-5 criteria for Mild NCD 48 months after cardiac surgery and a further 7.1% (on-pump) of them, for Major NCD. Clinical factors were associated with Mild NCD and both clinical and surgical factors, were associated with Major NCD.

A relevant incidence of long-term Mild NCD and Major NCD has been described 48 months after cardiac surgery, more intense in the on-pump group of patients. Assessment (identifying those with higher risk), prevention and treatment strategies for these patients should be provided. The DSM-5 criteria to classify NCD could be applied to characterize any cognitive decline due to any disease or surgical procedure.