[Interest of the Mini Mental State Examination to detect cognitive defects after cardiac surgery].
BACKGROUND
Cognitive defects are frequently described after cardiac surgery. They occur in 30 to 79% cases. They might be related to the use of a cardiopulmonary bypass (CPB). They are poorly evaluated in clinical practice.


OBJECTIVE
To evaluate the usefulness of the Mini Mental State Examination (MMSE) to screen patients scheduled for cardiac surgery.


METHODS
Prospective, open study.


METHODS
100 consecutive patients undergoing coronary artery bypass or valvular replacement under CPB were enrolled in the study. The MMSE was performed the day before surgery and five days later. Patients exhiting a postoperative defect> or =4 points were compared to those without changes or with improved results.


RESULTS
73 patients completed both tests. The mean score decreased postoperatively in 12 patients (15%). They were older (70+/-8 years), had longer CBP durations (128+/-50 min) and the lowest temperatures (30 degrees C+/-3) compared to the other patients. At the opposite, five patients (9%) improved their scores.


CONCLUSIONS
These results entourage to carry out a more strict follow-up for the oldest patients in cardiac surgery. The MMSE could be systematically integrated to the pre and postoperative screening. The detection of cognitive dysfunction should lead to address the patient to a geriatrician for a prolonged follow-up.
Weissrock
S
S
Département d'anesthésiologie, hôpital civil, 1, route de l'Hôpital, 67091 Strasbourg cedex, France. Sebastien.weissrock@chru-strasbourg.fr
Levy
F
F
Balabaud
V
V
Thiranos
J-C
JC
Dupeyron
J-P
JP
Steib
A
A
D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology*; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000175:diagnosis* / Q000523:psychology*; D011446:Prospective Studies