Luis M Pérez-Belmonte1, Mercedes Florido-Santiago, Julio Osuna-Sánchez, Miguel A Barbancho, Mercedes Millán-Gómez, Manuel F Jímenez-Navarro, M Rosa Bernal-López, Ricardo Gómez-Huelgas, José P Lara. 1. Luis M. Pérez-Belmonte, MD, PhD Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga, and Unidad de Neurofisiología Cognitiva, Centro de Investigaciones Médico Sanitarias, Campus de Excelencia Internacional Andalucía Tech, Instituto de Investigación Biomédica de Málaga, Universidad de Málaga; and Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain. Mercedes Florido-Santiago, MS Unidad de Neurofisiología Cognitiva, Centro de Investigaciones Médico Sanitarias, Campus de Excelencia Internacional Andalucía Tech, Instituto de Investigación Biomédica de Málaga, Universidad de Málaga, Spain. Julio Osuna-Sánchez, MD Unidad de Neurofisiología Cognitiva, Centro de Investigaciones Médico Sanitarias, Campus de Excelencia Internacional Andalucía Tech, Instituto de Investigación Biomédica de Málaga, Universidad de Málaga, Spain. Miguel A. Barbancho, MD, PhD Unidad de Neurofisiología Cognitiva, Centro de Investigaciones Médico Sanitarias, Campus de Excelencia Internacional Andalucía Tech, Instituto de Investigación Biomédica de Málaga, Universidad de Málaga, Spain. Mercedes Millán-Gómez, MN Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid; and Unidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga, Universidad de Málaga, Spain. Manuel F. Jímenez-Navarro, MD, PhD Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid; and Unidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga, Universidad de Málaga, Spain. M. Rosa Bernal-López, PhD Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga, Universidad de Málaga; and Ciber Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain. Ricardo Gómez-Huelgas, MD, PhD Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga, Universidad de Málaga; and Ciber Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain. José P. Lara, MD, PhD Unidad de Neurofisiología Cognitiva, Centro de Investigaciones Médico Sanitarias, Campus de Excelencia Internacional Andalucía Tech, Instituto de Investigación Biomédica de Málaga, Universidad de Málaga, Spain.
Abstract
BACKGROUND: Although postoperative cognitive dysfunction is a relevant complication after surgery, assessment for the condition is not routine in clinical practice. OBJECTIVE: The aim of this study was to compare the use of screening versus brief domain-specific cognitive tests in assessing long-term cognitive dysfunction after concomitant aortic valve replacement and coronary artery bypass grafting. METHODS: In this observational prospective study, we evaluated 70 patients preoperatively and after 1, 6, and 12 months using 2 screening tests (Mini-Mental State Examination and Clock Drawing Test) and 2 brief domain-specific cognitive tests (Trail Making Test to evaluate attention and executive function, and Semantic and Phonological Tests to evaluate verbal fluency). RESULTS: The brief domain-specific cognitive tests detected significant postoperative worsening in performances (up to 19% on the Trail Making Test and 15.4% on verbal fluency tests at 6 months). Postoperative mild attention/executive dysfunction or inferior normal performance was detected with the maximums being seen at 6 months (44.6%, P < .001). Performances on screening tests did not significantly change during the study period. CONCLUSIONS: A brief domain-specific cognitive evaluation could be routinely implemented in perioperative care practice to detect postoperative cognitive dysfunction.
BACKGROUND: Although postoperative cognitive dysfunction is a relevant complication after surgery, assessment for the condition is not routine in clinical practice. OBJECTIVE: The aim of this study was to compare the use of screening versus brief domain-specific cognitive tests in assessing long-term cognitive dysfunction after concomitant aortic valve replacement and coronary artery bypass grafting. METHODS: In this observational prospective study, we evaluated 70 patients preoperatively and after 1, 6, and 12 months using 2 screening tests (Mini-Mental State Examination and Clock Drawing Test) and 2 brief domain-specific cognitive tests (Trail Making Test to evaluate attention and executive function, and Semantic and Phonological Tests to evaluate verbal fluency). RESULTS: The brief domain-specific cognitive tests detected significant postoperative worsening in performances (up to 19% on the Trail Making Test and 15.4% on verbal fluency tests at 6 months). Postoperative mild attention/executive dysfunction or inferior normal performance was detected with the maximums being seen at 6 months (44.6%, P < .001). Performances on screening tests did not significantly change during the study period. CONCLUSIONS: A brief domain-specific cognitive evaluation could be routinely implemented in perioperative care practice to detect postoperative cognitive dysfunction.