Incidence of postoperative cognitive dysfunction after simultaneous carotid surgery and coronary artery bypass grafting in patients with asymptomatic cerebral atherosclerosis

Малева, О. В.; Трубникова, О. А.; Сырова, И. Д.; Solodukhin, A.V.; Головин, А А; Барбараш, О. Л.; Барбараш, Л. С.

doi:10.17116/jnevro20201200325

Cited by 7 publications

(4 citation statements)

References 24 publications

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“…[ 1 ] It is been found that patients with cardiovascular surgery had a higher incidence of postoperative cognitive impairment. [ 2 , 3 ] With the deepening of the research, it has found that POCD also has a certain incidence in patients with non-cardiovascular surgery. Several studies [ 4 , 5 ] have found that the incidence of POCD in non-cardiac surgery under general anesthesia vary from 3.5% to 25.8%.…”

Section: Introductionmentioning

confidence: 99%

The risk factors for cognitive dysfunction in elderly patients after laparoscopic surgery

Fan¹,

Liu²,

Wu³

et al. 2021

Medicine

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Postoperative cognitive dysfunction (POCD) is very common in clinical settings, it is necessary to analyze the risk factors for POCD in elderly patients after laparoscopic surgery to provide insights into clinical surgery management. Elderly patients undergone laparoscopy between September 1, 2018 and March 31, 2020 were included. The mini-mental state examination (MMSE) scale was used to evaluate the POCD, and the characteristics and clinical data of patients with and without POCD were collected and compared. Logistic regression was used to analyze the potential influencing factors. A total of 572 patients with laparoscopic surgery were included. The incidence of POCD was 11.89%. There were significant differences in the history of cerebral infarction, preemptive analgesia, preoperative use of dexmedetomidine, general anesthesia combined with continuous epidural block, duration of surgery, low SpO2 during anesthesia induction, PaCO2 after pneumoperitoneum, postoperative PCEA and VAS score at the third day after operation (all P < .05). Logistic regression analysis revealed that history of cerebral infarction (OR3.12, 1.02∼5.13), low SpO2 during anesthesia induction (OR2.03, 1.19∼4.47), Longer duration of surgery (OR1.82, 1.01∼3.16) were risk factors for POCD in elderly patients with laparoscopic surgery, while postoperative PCEA (OR0.43, 0.01∼0.91), General anesthesia combined with continuous epidural block (OR0.59, 0.04∼0.87), preoperative use of dexmedetomidine (OR0.70, 0.08∼0.94) and preemptive analgesia (OR0.75, 0.13–0.90) were the protective factors for POCD in elderly patients with laparoscopic surgery. For the elderly patients undergoing laparoscopic surgery, the health care providers should be fully alert to the POCD based on those relevant factors.

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Section: Introductionmentioning

confidence: 99%

The risk factors for cognitive dysfunction in elderly patients after laparoscopic surgery

Fan¹,

Liu²,

Wu³

et al. 2021

Medicine

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“…In this study, contrary to our hypothesis, we did not find an association between the incidence of DNR and cognitive frailty. As noted in previous work, some studies showed no significant difference in the incidence of DNR between MCI and non-MCI patients (Bekker et al, 2010 ; Trubnikova et al, 2014 ; Maleva et al, 2020 ), which indicated that MCI might not be a predictor for DNR. Although some studies have shown that frailty is an essential factor in cognitive dysfunction (Siejka et al, 2022 ), they are mostly based on community-dwelling elderly samples, and the majority of studies have mainly focused on exploring the relationship between frailty and long-term changes in cognitive function.…”

Section: Discussionmentioning

confidence: 72%

Does cognitive frailty predict delayed neurocognitive recovery after noncardiac surgery in frail elderly individuals? Probably not

Zhang

Basnet

et al. 2022

Front. Aging Neurosci.

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IntroductionDelayed neurocognitive recovery (DNR) is a common post-surgical complication among the elderly. Cognitive frailty (CF) is also an age-related medical syndrome. However, little is known about the association between CF and DNR. Therefore, this study aimed to study whether CF is associated with DNR in elderly patients undergoing elective noncardiac surgery, as well as to explore the potential risk factors for DNR in frail elderly individuals and construct a prediction model.MethodsThis prospective cohort study administered a battery of cognitive and frailty screening instruments for 146 individuals (≥65 years old) scheduled for elective noncardiac surgery. Screening for CF was performed at least one day before surgery, and tests for the presence of DNR were performed seven days after surgery. The association between CF and DNR was investigated. Moreover, the study subjects were randomly divided into a modeling group (70%) and a validation group (30%). Univariate and multivariate logistic regression was performed to analyze the modeling group data and identify the independent risk factors for DNR. The R software was used to construct DNR's nomogram model, verifying the model.ResultsIn total, 138 individuals were eligible. Thirty-three cases were diagnosed with DNR (23.9%). No significant difference in the number of patients with CF was observed between the DNR and non-DNR groups (P > 0.05). Multivariate analysis after adjusting relevant risk factors showed that only the judgment of line orientation (JLOT) test score significantly affected the incidence of DNR. After internal validation of the constructed DNR prediction model, the area under the curve (AUC) of the forecast probability for the modeling population (n = 97) for DNR was 0.801, and the AUC for the validation set (n = 41) was 0.797. The calibration curves of both the modeling and validation groups indicate that the prediction model has good stability.ConclusionCognitive frailty is not an independent risk factor in predicting DNR after noncardiac surgery in frail elderly individuals. The preoperative JLOT score is an independent risk factor for DNR in frail elderly individuals. The prediction model has a good degree of discrimination and calibration, which means that it can individually predict the risk probability of DNR in frail elderly individuals.

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“…Малевой и соавт. [28] подчеркнута необходимость учета пред-и послеоперационного клинического статуса пациентов с асимптомным чески значимые различия между фронтальными и парието-окципитальными отделами после одномоментного вмешательства (p = 0,018). атеросклерозом брахиоцефальных сосудов, одномоментно перенесших каротидную эндартерэктомию и коронарное шунтирование.…”

Section: Original Studiesunclassified

Impact of preoperative cognitive impairment on changes in electrical activity of the brain in patients undergoing combined carotid endarterectomy and coronary artery bypass grafting

Тарасова

Kupriyanova

Трубникова

et al. 2023

Kompleks. probl. serdečno-sosud. zabol.

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HighlightsThe presence of preoperative mild cognitive impairment (MCI) in patients undergoing combined carotid endarterectomy and coronary artery bypass grafting is associated with an increased theta activity at the frontal and parieto-occipital regions of both hemispheres after surgery. AbstractAim. To study the impact of preoperative cognitive impairment on changes in electrical activity of the brain in patients undergoing combined carotid endarterectomy and coronary artery bypass grafting.Methods. Sixty-three patients undergoing combined carotid endarterectomy (CAE) and coronary artery bypass grafting (CABG) were included in the study. The patients were divided into three groups, depending on the preoperative cognitive functions: without cognitive impairment (n = 17), with MCI (n = 29), and with severe cognitive impairment (n = 17). High-resolution electroencephalography (EEG) (62 channels, bandpass filtered between 0.1–50.0 Hz, sampling rate of 1000 Hz) was performed 3–5 days before and 7–10 days after surgery.Results. Patients with severe cognitive impairment at baseline presented with higher theta activity at the frontal region of the left hemisphere compared to patients without cognitive impairment and patients with MCI (p = 0.048). At the same time, patients with MCI showed the most pronounced theta activity increase after surgery compared to preoperative levels at the frontal and parieto-occipital cortical regions of both the left and right hemispheres (p≤0.05). Postoperative changes of theta activity in patients with severe cognitive impairment were minimal and statistically insignificant.Conclusion. Patients without severe preoperative cognitive impairment presented with higher grade brain dysfunction in the form of increased theta activity at the frontal and parieto-occipital regions after combined CAE and CABG. A smaller decrease in theta power after surgery in patients with severe preoperative cognitive impairment, on the one hand, can indicate compensation after cerebral ischemia and resistance to hypoperfusion during on-pump cardiac surgery, and on the other, can be a manifestation of the ceiling effect and insufficiency of brain functional reserves.

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Incidence of postoperative cognitive dysfunction after simultaneous carotid surgery and coronary artery bypass grafting in patients with asymptomatic cerebral atherosclerosis

Cited by 7 publications

References 24 publications

The risk factors for cognitive dysfunction in elderly patients after laparoscopic surgery

The risk factors for cognitive dysfunction in elderly patients after laparoscopic surgery

Does cognitive frailty predict delayed neurocognitive recovery after noncardiac surgery in frail elderly individuals? Probably not

Impact of preoperative cognitive impairment on changes in electrical activity of the brain in patients undergoing combined carotid endarterectomy and coronary artery bypass grafting

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