title: Frequency and predictors of cognitive decline in patients undergoing coronary artery bypass graft surgery.
abstract: OBJECTIVE
  To determine the frequency of cognitive impairment and its predictors in patients, who underwent first time coronary artery bypass graft surgery (CABGS).
  
  
  METHODS
  An observational study.
  
  
  METHODS
  The National Institute of Cardiovascular Diseases (NICVD), Karachi, from December 2008 to December 2009.
  
  
  METHODS
  Study included patients > 18 years, who underwent first-time elective CABGS. Emergency CABGS, with additional cardiac procedures, myocardial infarction (MI) within one month and known psychiatric illness were excluded. Patients were evaluated for their socio-demographic profile, medical history, intra-operative, anesthetic and surgical techniques and postoperative complications/therapy in ICU. Cognitive functioning, before the surgery, at discharge, 6 weeks and 6 months post-CABG was evaluated by McNair's and MMSE scales. HDRS was added to see if depression was a confounding factor for cognitive decline.
  
  
  RESULTS
  One hundred and thirty four patients were followed-up at discharge, 74 at 6 weeks and 73 at 6 months. There were 113 (84.3%) males and 21 (15.7%) females, with mean age of 53.7 ± 8.36 years. Prevalence of cognitive disturbance at baseline was 44.8%, which increased to 54.5% at discharge, and improvement was seen at 6 months, it was 39.7%. Older age, female gender, higher bleeding episodes, and high post-surgery creatinine level were more frequently associated with cognitive decline.
  
  
  CONCLUSIONS
  Postoperative cognitive deficit was common and remained persistent at short-term. Older age, females and high postoperative creatinine were identified as its important predictors. There was high frequency of acute depression before surgery with significant reduction over time.
authors.affiliation: Department of Adult Cardiology , National Institute of Cardiovascular Disease (NICVD), Karachi.
authors.forename: Sultana
authors.initials: S
authors.lastname: Habib
authors.affiliation: Department of Cardiovascular Surgery , National Institute of Cardiovascular Disease (NICVD), Karachi.
authors.forename: Arif ur Rehman
authors.initials: Au
authors.lastname: Khan
authors.affiliation: Department of Psychiatry, Jinnah Postgraduate Medical Centre (JPMC), Karachi.
authors.forename: M Iqbal
authors.initials: MI
authors.lastname: Afridi
authors.affiliation: Department of Research Assistant , National Institute of Cardiovascular Disease (NICVD), Karachi.
authors.forename: Anum
authors.initials: A
authors.lastname: Saeed
authors.affiliation: Department of Cath Lab , National Institute of Cardiovascular Disease (NICVD), Karachi.
authors.forename: Agha Fahad
authors.initials: AF
authors.lastname: Jan
authors.affiliation: Department of Anaesthesia , National Institute of Cardiovascular Disease (NICVD), Karachi.
authors.forename: Najma
authors.initials: N
authors.lastname: Amjad
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000601:surgery*; D003404:Creatinine / Q000097:blood; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D016896:Treatment Outcome
chemical_list: D003404:Creatinine