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Cerebral dysfunction after cardiac operations in elderly patients
E J Heyer1, E Delphin, D C Adams
1Department of Anesthesiology, Columbia University, New York, New York 10032-3784, USA.
The Annals of Thoracic Surgery
|December 1, 1995
Summary
Elderly patients undergoing open chamber cardiac operations show increased early cerebral dysfunction compared to younger patients or those having noncardiac surgery. These cognitive changes are temporary and do not persist long-term.
Area of Science:
- Neurology
- Cardiology
- Geriatrics
Background:
- Cerebral injury is a known complication of cardiac surgery.
- Assessing cerebral dysfunction incidence in elderly cardiac surgery patients is crucial.
Purpose of the Study:
- To compare the incidence of cerebral dysfunction in elderly patients undergoing open chamber cardiac operations versus younger cardiac surgery patients and age-matched noncardiac surgery patients.
Main Methods:
- Prospective study of 68 patients (cardiac vs. noncardiac, elderly vs. younger).
- Preoperative and postoperative neurologic examinations and neuropsychometric testing.
- Follow-up testing at later stages.
Main Results:
- All groups showed new primitive reflexes postoperatively, with no significant difference.
- Group 1 (elderly cardiac) showed distinct neuropsychometric performance differences early post-op compared to groups 2 and 3.
- These differences resolved by late follow-up.
Conclusions:
- Elderly patients undergoing open chamber cardiac operations experience more early postoperative cerebral dysfunction.
- This dysfunction is more pronounced than in younger cardiac surgery patients or elderly noncardiac surgery patients.
- Cognitive deficits are transient and do not persist long-term.