Investigation of factors relating to neuropsychological change following cardiac surgery.
BACKGROUND
An analysis of neuropsychological impairment following cardiopulmonary bypass was performed in 55 patients undergoing elective coronary artery bypass grafting.


METHODS
Neurocognitive function was measured preoperatively using the MicroCog: Assessment of Cognitive Functioning computer-based testing tool. Testing was repeated in the postoperative period immediately prior to discharge from hospital. Analysis of significant score decline was performed using the standardised regression-based technique. A patient was classified as overall impaired when > or = 20% of test scores were significantly impaired. The proposed marker of neurological damage S-100beta was also used. Prothrombin Fragment 1+2 (F1+2) was measured as a marker of thrombin development to test the hypothesis that excessive haemostatic activation may lead to thromboembolic damage to the brain.


CONCLUSIONS
32.7% of patients were classified as significantly impaired. No relationship was detected between F1+2 and any neuropsychological test score; however, the study was limited due to small sample size. F1+2 levels were higher in patients undergoing prolonged bypass times. Neuropsychological decline was significantly correlated with patient age, suggesting a degree of caution is warranted when operating on an elderly cohort. An unexpected relationship was detected between higher heparin concentrations and increased risk of neuropsychological impairment; however, this requires re-evaluation.
Raymond
Paul D
PD
Research Concentration in Biological and Medical Sciences, School of Life Sciences, Queensland University of Technology, Brisbane, Australia. p.raymond@optusnet.com.au
Radel
Michael
M
Ray
Michael J
MJ
Hinton-Bayre
Anton D
AD
Marsh
Neville A
NA
D000367:Age Factors; D000368:Aged; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D017558:Elective Surgical Procedures; D005260:Female; D006493:Heparin / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010446:Peptide Fragments / Q000097:blood; D011184:Postoperative Period; D011516:Prothrombin; D012307:Risk Factors
D010446:Peptide Fragments; C045879:prothrombin fragment 1.2; D011516:Prothrombin; D006493:Heparin