Sabrina Kastaun1, Tibo Gerriets2, Niko P Schwarz3, Mesut Yeniguen2, Markus Schoenburg4, Christian Tanislav5, Martin Juenemann6. 1. Department of Neurology, Heart and Brain Research Group, University Hospital Giessen and Marburg, Giessen, Germany;; Department of Cardiac Surgery, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany; 2. Department of Neurology, Heart and Brain Research Group, University Hospital Giessen and Marburg, Giessen, Germany;; Department of Neurology, Community Hospital Friedberg, Friedberg, Germany. 3. Department of Neurology, Heart and Brain Research Group, University Hospital Giessen and Marburg, Giessen, Germany;; Vitanas Geriatric Hospital MV, Berlin, Germany. 4. Department of Cardiac Surgery, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany; 5. Department of Neurology, Heart and Brain Research Group, University Hospital Giessen and Marburg, Giessen, Germany; 6. Department of Neurology, Heart and Brain Research Group, University Hospital Giessen and Marburg, Giessen, Germany;; Department of Neurology, Community Hospital Friedberg, Friedberg, Germany. Electronic address: martin.juenemann@neuro.med.uni-giessen.de.
Abstract
OBJECTIVES: Postoperative cognitive decline (POCD) has a perceivable influence on daily living and is noticed more often by close relatives than by patients themselves 3 months after aortic valve replacement. This study aimed to elucidate the longitudinal course of the subjective awareness of POCD. DESIGN: Follow-up of a prospective observational study. SETTING: A single cardiothoracic center in Germany. PARTICIPANTS: The study included 108 patients scheduled for elective aortic valve replacement surgery and 85 close relatives of the patients. INTERVENTIONS: In addition to conducting a neuropsychologic examination, the authors previously interviewed 82 patients with a Cognitive Failure Questionnaire for self-assessment (s-CFQ), and 62 relatives with the Cognitive Failure Questionnaire for others (f-CFQ) before and 3 months after surgery. Up until 12 months after surgery, the authors continuously interviewed additional patients (baseline and 3 months after surgery), thereby enlarging the original sample, and included the entire group (108 patients, 85 relatives) for the 12-month follow-up. RESULTS: The analysis showed that relatives (p = 0.026) and patients experienced patients' cognitive decline 3 months after surgery (p = 0.009). All changes still were observed in questions related to memory and attention. After 1 year, the s-CFQ no longer differed between baseline and postoperative assessment. Mean scores in the f-CFQ still were above baseline, barely missing statistical significance (p = 0.051). In patients with "change to worse" in the f-CFQ at 1-year follow-up, declining cognitive results in nonverbal learning (p = 0.021) could be observed 3 months postoperatively. Only a decrease in 3-month f-CFQ correlated with a decline in specific neuropsychologic tests 3 months after surgery. CONCLUSIONS: Contrary to the authors' previous results, the impact of POCD on daily living functions also was recognized by the patients themselves. The long-term influence and the associations between subjective deficits and psychometric cognitive measures seemed to be assessed more reliably by close relatives.
OBJECTIVES:Postoperative cognitive decline (POCD) has a perceivable influence on daily living and is noticed more often by close relatives than by patients themselves 3 months after aortic valve replacement. This study aimed to elucidate the longitudinal course of the subjective awareness of POCD. DESIGN: Follow-up of a prospective observational study. SETTING: A single cardiothoracic center in Germany. PARTICIPANTS: The study included 108 patients scheduled for elective aortic valve replacement surgery and 85 close relatives of the patients. INTERVENTIONS: In addition to conducting a neuropsychologic examination, the authors previously interviewed 82 patients with a Cognitive Failure Questionnaire for self-assessment (s-CFQ), and 62 relatives with the Cognitive Failure Questionnaire for others (f-CFQ) before and 3 months after surgery. Up until 12 months after surgery, the authors continuously interviewed additional patients (baseline and 3 months after surgery), thereby enlarging the original sample, and included the entire group (108 patients, 85 relatives) for the 12-month follow-up. RESULTS: The analysis showed that relatives (p = 0.026) and patients experienced patients' cognitive decline 3 months after surgery (p = 0.009). All changes still were observed in questions related to memory and attention. After 1 year, the s-CFQ no longer differed between baseline and postoperative assessment. Mean scores in the f-CFQ still were above baseline, barely missing statistical significance (p = 0.051). In patients with "change to worse" in the f-CFQ at 1-year follow-up, declining cognitive results in nonverbal learning (p = 0.021) could be observed 3 months postoperatively. Only a decrease in 3-month f-CFQ correlated with a decline in specific neuropsychologic tests 3 months after surgery. CONCLUSIONS: Contrary to the authors' previous results, the impact of POCD on daily living functions also was recognized by the patients themselves. The long-term influence and the associations between subjective deficits and psychometric cognitive measures seemed to be assessed more reliably by close relatives.
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