title: Assessment of long-term cognitive impairment after off-pump coronary-artery bypass grafting and related risk factors.
abstract: OBJECTIVE
  To assess cognitive impairment after off-pump coronary-artery bypass grafting, with a particular emphasis on long-term follow-up and related risk factors.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Virgen de la Victoria University Hospital, Málaga, Spain.
  
  
  METHODS
  Participants were 36 patients undergoing off-pump coronary-artery bypass grafting.
  
  
  METHODS
  Changes in the neuropsychological test battery administered from before to after surgery (1, 6, and 12 months). Postoperative cognitive impairment was defined by a significant decrease.
  
  
  RESULTS
  A significantly multidomain (attention-executive functions, P < .01; immediate and delayed memory, P < .001; and verbal fluency, P < .05) postoperative cognitive impairment was shown, being maximum at 6 months (more than 50% of patients) and still presented at 12 months (more than 30% of patients), but partially recovered. Related risk factors as smoking (P < .01), diabetes mellitus (P < .01), peripheral arteriopathy (P < .01), obesity (P < .05), lower hematocrit (P < .01), and hemoglobin (P < .05) levels and diastolic blood pressure (P < .05) were identified as predictors of cognitive impairment. Better New York Heart Association class (P < .01) and less severity of angina (P < .01) were associated with partial postoperative recovering.
  
  
  CONCLUSIONS
  A multidomain long-term postoperative cognitive impairment and a partial neurocognitive recovering were detected after off-pump coronary-artery bypass grafting and were associated with several nonspecific surgery factors. These findings may be useful when counseling patients before surgery and suggest the importance of long-term neurocognitive evaluation.
authors: CMU (Clinical Management Unit) of Heart Department, Virgen de la Victoria University Hospital, Málaga, Spain; Unit of Cognitive Neurophysiology, Research Medical Center of Málaga University, ICE (International Campus of Excellence) Andalucía Tech, BRIM (Biomedical Research Institute of Málaga), Málaga, Spain. Electronic address: luismiguelpb@hotmail.com.
authors: Luis M
authors: LM
authors: Pérez-Belmonte
authors: Department of Internal Medicine, Axarquía County Hospital, Vélez-Málaga, Málaga, Spain.
authors: Carlos M
authors: CM
authors: San Román-Terán
authors: CMU (Clinical Management Unit) of Heart Department, Virgen de la Victoria University Hospital, Málaga, Spain.
authors: Manuel
authors: M
authors: Jiménez-Navarro
authors: Unit of Cognitive Neurophysiology, Research Medical Center of Málaga University, ICE (International Campus of Excellence) Andalucía Tech, BRIM (Biomedical Research Institute of Málaga), Málaga, Spain.
authors: Miguel A
authors: MA
authors: Barbancho
authors: Department of Psychiatry, Unit of Dementia, Andalusia Institute of Neuroscience and Conduct, Málaga, Spain.
authors: José M
authors: JM
authors: García-Alberca
authors: Unit of Cognitive Neurophysiology, Research Medical Center of Málaga University, ICE (International Campus of Excellence) Andalucía Tech, BRIM (Biomedical Research Institute of Málaga), Málaga, Spain.
authors: José P
authors: JP
authors: Lara
mesh_terms: D000368:Aged; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D015331:Cohort Studies; D016001:Confidence Intervals; D017023:Coronary Angiography / Q000379:methods; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects* / Q000379:methods / Q000523:psychology; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013030:Spain; D013997:Time Factors; D016896:Treatment Outcome
keywords: Postoperative cognitive impairment; cognitive domain; coronary-artery bypass grafting; off-pump; predictors of cognitive impairment; risk factors