title: Preoperative depression is a risk factor for postoperative short-term and long-term cognitive dysfunction in patients with diabetes mellitus.
abstract: OBJECTIVE
  To identify whether the presence of preoperative depression in patients with diabetes mellitus is a risk factor for postoperative cognitive dysfunction after coronary artery bypass graft (CABG) surgery.
  
  
  METHODS
  Data from 90 patients with diabetes mellitus undergoing elective CABG were analyzed. Hemodynamic data (arterial and jugular venous blood gas values) were measured during cardiopulmonary bypass. Preoperatively, all patients were given the 21-item Beck depression inventory to identify the presence of depression. In addition, all patients underwent a battery of neurological and neuropsychological tests the day before surgery, 7 days after surgery, and 6 months after surgery.
  
  
  RESULTS
  The rate of cognitive dysfunction was 50% at 7 days and 23% at 6 months after surgery. Age, hypertension, presence of depression, duration of SjvO(2) ≤ 50%, ascending aorta atherosclerosis, diabetic retinopathy, and insulin therapy were independent predictors of short-term cognitive dysfunction, whereas HbA1c, diabetic retinopathy, insulin therapy, and presence of depression were independent predictors of long-term cognitive dysfunction.
  
  
  CONCLUSIONS
  We found that the presence of depression preoperatively is associated with short-term and long-term postoperative cognitive dysfunction in patients with diabetes mellitus.
authors.affiliation: Department of Anesthesiology, Gunma University School of Medicine, 3-39-22 Showa-Machi, Maebashi, Gunma 371-8511, Japan. kadoi@med.gunma-u.ac.jp
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kadoi
authors.forename: Chikara
authors.initials: C
authors.lastname: Kawauchi
authors.forename: Masanobu
authors.initials: M
authors.lastname: Ide
authors.forename: Masataka
authors.initials: M
authors.lastname: Kuroda
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Takahashi
authors.forename: Shigeru
authors.initials: S
authors.lastname: Saito
authors.forename: Nao
authors.initials: N
authors.lastname: Fujita
authors.forename: Akio
authors.initials: A
authors.lastname: Mizutani
mesh_terms: D000368:Aged; D000768:Anesthesia, General; D000777:Anesthetics; D001784:Blood Gas Analysis; D003072:Cognition Disorders / Q000209:etiology* / Q000523:psychology*; D001026:Coronary Artery Bypass / Q000523:psychology; D003863:Depression / Q000150:complications* / Q000523:psychology*; D048909:Diabetes Complications / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000523:psychology; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000523:psychology*; D057234:Preoperative Period; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors
chemical_list: D000777:Anesthetics