The risk of cognitive decline after not undergoing coronary artery bypass grafting: preliminary results

Keizer, Annemieke M. A.; Dijk, Diederik van; Hijman, Ron; Kalkman, C.; Kahn, Robert S.

doi:10.1016/s0003-4975(01)03479-8

Cited by 2 publications

(5 citation statements)

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“…The cognitive results at 3 months and 12 months after surgery have been reported elsewhere. 6,8 The tests were administered by a trained psychologist blinded to treatment allocation. Each individual's performance on the neuropsychological tests was compared with his or her performance on the same tests 5 year earlier, on the day before surgery.…”

Section: Neuropsychological Assessmentmentioning

confidence: 99%

“…A "standard" definition was used in the initial Octopus Study and defined cognitive decline as a decrease in a patient's performance of at least 20% from baseline in at least 20% (ie, 3) of the 11 main variables. 14 Since this definition later appeared to also identify healthy controls as having cognitive decline, 6 an alternative, more conservative definition was used that corrects for the natural variation in performance during repeated testing. 6 Cognitive decline is defined herein as deterioration beyond the normal variation in cognitive performance observed within a short interval (3 months) in a control population of healthy volunteers.…”

Section: Definitions Of Cognitive Declinementioning

confidence: 99%

“…14 Since this definition later appeared to also identify healthy controls as having cognitive decline, 6 an alternative, more conservative definition was used that corrects for the natural variation in performance during repeated testing. 6 Cognitive decline is defined herein as deterioration beyond the normal variation in cognitive performance observed within a short interval (3 months) in a control population of healthy volunteers. The scores of 8 main variables were standardized using the formula of reliable change (RC) as proposed by Jacobson and Truax 15 : RC = ([performance at 5 years − performance at baseline]−practice effect)/SD diff .…”

Section: Definitions Of Cognitive Declinementioning

confidence: 99%

“…There are many different ways in which to define cognitive decline. 2,6,26 The standard definition that was used (20% decrease in performance in 20% of the variables) appears to have limited precision. Although this definition has been reported to be sensitive and reliable, 14 it was demonstrated recently that the cutoff value may be within the range of an individual's natural fluctuation in performance.…”

Section: Commentmentioning

confidence: 99%

“…Although this definition has been reported to be sensitive and reliable, 14 it was demonstrated recently that the cutoff value may be within the range of an individual's natural fluctuation in performance. 6,26 Therefore, the true incidence of cognitive decline at 5-year follow-up is probably better reflected by the alternative, more conservative definition, which takes these natural fluctuations into account. 15 Apart from 2 perioperative cardiovascular deaths in the on-pump group, only noncardiac mortality occurred during the follow-up.…”

Section: Commentmentioning

confidence: 99%

See 4 more Smart Citations

Cognitive and Cardiac Outcomes 5 Years After Off-Pump vs On-Pump Coronary Artery Bypass Graft Surgery

Dijk

Spoor²,

Hijman³

et al. 2007

JAMA

272

167

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for the Octopus Study Group C ORONARY ARTERY BYPASS graft (CABG) surgery effectively relieves angina but is associated with significant cerebral morbidity. 1 This has largely been attributed to the use of cardiopulmonary bypass. 1,2 Cardiopulmonary bypass requires cannulation and crossclamping of the ascending aorta, which may dislodge atheromatous macroemboli, leading to stroke. 3 Cardiopulmonary bypass also increases the permeability of the blood-brain barrier and generates microemboli, which may adversely affect cognitive function. 4,5 The incidence of cognitive decline in the first year after surgery ranges from less than 5% to more than 30%, depending both on patient characteristics and on the definition of decline that is used. 2,6 Stroke occurs in approximately 3% of patients undergoing CABG surgery. 1 The desire to avoid the perceived ill effects of cardiopulmonary bypass has led to a renewed interest in bypass surgery on the beating heart (off-pump CABG surgery). This has been stimulated by the development of cardiac stabilizers, which facilitate the construc-Author Affiliations: Departments of Anesthesiology (Drs van Dijk and Kalkman and Ms Spoor), Psychiatry (Dr Hijman), Cardiology (Drs Nathoe and Borst), and Cardiothoracic Surgery (Dr Jansen

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Section: Neuropsychological Assessmentmentioning

confidence: 99%