title: Association between Perioperative Parameters and Cognitive Impairment in Post-Cardiac Surgery Patients.
abstract: BACKGROUND
  Postoperative cognitive dysfunction (POCD) has been an important complication of cardiac surgery over the years. Neurocognitive dysfunction can affect quality of life and lead to social, functional, emotional, and financial problems in the patient's life. To reduce POCD, we sought to identify the association between cognitive dysfunction and perioperative factors in patients undergoing cardiac surgery.
  
  
  METHODS
  One hundred one patients aged between 45 and 75 years undergoing elective cardiac surgery were enrolled in this study. All the surgeries were performed on-pump by the same medical team. A brief Wechsler Memory Test (WMT) was administered before surgery, 3 to 5 days after the surgery, and 3 months after discharge. All related perioperative parameters were collected in order to study the effect of these parameters on the postoperative WMT scores and WMT score change.
  
  
  RESULTS
  The study population consisted of 101 patients, comprising 14 (13.8%) females and 87 (86.2%) males aged between 45 and 75 years. In univariate analysis, the baseline WMT score, serum levels of lactate dehydrogenase and T3, cross-clamp time, and preexistence of chronic obstructive pulmonary disease showed significant effects on the postoperative WMT score (p value < 0.05), whereas only the baseline WMT score and chronic obstructive pulmonary disease showed strong effects on the postoperative WMT score in the multiple regression model. In addition, the multiple regression model demonstrated a significant association between the baseline WMT score, serum creatinine level, and nitrate administration and the WMT score change.
  
  
  CONCLUSIONS
  Our study showed that preexisting chronic obstructive pulmonary disease and preoperative high serum creatinine levels negatively affected cognitive function after surgery. In addition, there was a strong relationship between the patients' basic cognition and POCD. Preoperative nitrate administration led to a significant improvement in POCD. It is also concluded that the preoperative administration of specific medicines like nitrates can reduce neurological complications after cardiac surgery.
authors.affiliation: Department of Pharmacotherapy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Saba
authors.initials: S
authors.lastname: Ghaffary
authors.affiliation: Department of Pharmacotherapy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. ; Tehran Heart Centre, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Azita
authors.initials: A
authors.lastname: Hajhossein Talasaz
authors.affiliation: Department of Pharmacotherapy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Padideh
authors.initials: P
authors.lastname: Ghaeli
authors.affiliation: Tehran Heart Centre, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Abbasali
authors.initials: A
authors.lastname: Karimi
authors.affiliation: Tehran Heart Centre, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Salehiomran
authors.affiliation: Tehran Heart Centre, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Hajighasemi
authors.affiliation: Tehran Heart Centre, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Payvand
authors.initials: P
authors.lastname: Bina
authors.affiliation: Tehran Heart Centre, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Sayeh
authors.initials: S
authors.lastname: Darabi
authors.affiliation: Tehran Heart Centre, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Arash
authors.initials: A
authors.lastname: Jalali
authors.affiliation: Department of Pharmacotherapy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mehrnoush
authors.initials: M
authors.lastname: Dianatkhah
authors.affiliation: Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Noroozian
authors.affiliation: Tehran Heart Centre, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Nazila
authors.initials: N
authors.lastname: Shahmansouri
keywords: Cardiac surgical procedure; Cognition disorders; Creatinine; Pulmonary disease; chronic obstructive