Effect of Patient Sex on Neurocognitive Decline after Cardiac Surgery.

Autor:	Stanley ME; From the Division of Cardiothoracic Surgery, Warren Alpert Medical School at Brown University and Rhode Island Hospital, Providence, RI (Stanley, Sabe, Sodha, Ehsan, Sellke)., Kant S; the Warren Alpert Medical School at Brown University, Providence, RI (Kant)., Raker C; Lifespan Biostatistics, Epidemiology, and Research Design Core, Providence, RI (Raker)., Sabe S; From the Division of Cardiothoracic Surgery, Warren Alpert Medical School at Brown University and Rhode Island Hospital, Providence, RI (Stanley, Sabe, Sodha, Ehsan, Sellke)., Sodha NR; From the Division of Cardiothoracic Surgery, Warren Alpert Medical School at Brown University and Rhode Island Hospital, Providence, RI (Stanley, Sabe, Sodha, Ehsan, Sellke)., Ehsan A; From the Division of Cardiothoracic Surgery, Warren Alpert Medical School at Brown University and Rhode Island Hospital, Providence, RI (Stanley, Sabe, Sodha, Ehsan, Sellke)., Sellke FW; From the Division of Cardiothoracic Surgery, Warren Alpert Medical School at Brown University and Rhode Island Hospital, Providence, RI (Stanley, Sabe, Sodha, Ehsan, Sellke).
Jazyk:	angličtina
Zdroj:	Journal of the American College of Surgeons [J Am Coll Surg] 2023 Jun 01; Vol. 236 (6), pp. 1112-1124. Date of Electronic Publication: 2023 Jan 20.
DOI:	10.1097/XCS.0000000000000574
Abstrakt:	Background: Neurocognitive decline (NCD) is a common complication of cardiac surgery. Understanding risk factors helps surgeons counsel patients pre- and perioperatively about risk, prevention, and treatment. Study Design: Patients undergoing cardiac surgery using cardiopulmonary bypass underwent pre- and postoperative neurocognitive testing. Neurocognitive data are presented as a change from baseline to either postoperative day 4 or to 1 month. The score is standardized with respect to age. Results: Eighty-four patients underwent surgery and completed postoperative neurocognitive testing. There was no significant difference in baseline neurocognitive function. NCD was more common in female patients (71%) than male patients (26.4%) on postoperative day 4. By 1 month, the incidence of NCD is similar between female (15.0%) and male patients (14.3%). Of note, female patients differed from male patients in preoperative hematocrit, preoperative creatinine, and type of surgery. Conclusions: In the acute postoperative period, female patients are both more likely to experience NCD and experience a more severe change from baseline cognitive function. This difference between male and female patients resolves by the 1 month follow-up point. Female patients had a lower preoperative hematocrit and were more likely to receive intraoperative and perioperative blood transfusion. Lower preoperative hematocrit appears to mediate the difference in NCD between male and female patients. (Copyright © 2023 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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