title: Cerebral dysfunction after cardiac operations in elderly patients.
abstract: BACKGROUND
  Cerebral injury remains a significant complication of cardiac operations. We determined the incidence of cerebral dysfunction in a population of elderly patients undergoing open chamber cardiac operations (group 1) as compared with a younger population (group 2) and an age-matched group of elderly patients undergoing major noncardiac operations (group 3).
  
  
  METHODS
  Sixty-eight patients (55 for open chamber cardiac operations and 13 for noncardiac operations) were prospectively studied. Patients were evaluated preoperatively and postoperatively before hospital discharge using a complete neurologic examination and a battery of standard neuropsychometric tests, and at surgical follow-up with neuropsychometric tests only.
  
  
  RESULTS
  Postoperative changes detected by neurologic examination consisted of the appearance of new primitive reflexes in all groups. No statistically significant differences in incidence were found. The neuropsychometric performance of group 1 patients was statistically different from that of patients in groups 2 and 3 only in the early follow-up period.
  
  
  CONCLUSIONS
  Elderly patients having open chamber cardiac operations exhibit significantly more cerebral dysfunction in the early postoperative period than those undergoing major noncardiac operations and younger patients after open chamber procedures. These changes do not persist into the late follow-up period.
authors.affiliation: Department of Anesthesiology, Columbia University, New York, New York 10032-3784, USA.
authors.forename: E J
authors.initials: EJ
authors.lastname: Heyer
authors.forename: E
authors.initials: E
authors.lastname: Delphin
authors.forename: D C
authors.initials: DC
authors.lastname: Adams
authors.forename: E A
authors.initials: EA
authors.lastname: Rose
authors.forename: C R
authors.initials: CR
authors.lastname: Smith
authors.forename: C J
authors.initials: CJ
authors.lastname: Todd
authors.forename: M
authors.initials: M
authors.lastname: Ginsburg
authors.forename: R
authors.initials: R
authors.lastname: Haggerty
authors.forename: D J
authors.initials: DJ
authors.lastname: McMahon
mesh_terms: D000367:Age Factors; D000368:Aged; D001927:Brain Diseases / Q000209:etiology*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009460:Neurologic Examination; D011446:Prospective Studies; D012018:Reflex