Patient-Reported Postoperative Neuropsychological Deterioration After Heart Valve Replacement and Coronary Artery Bypass Grafting.

Autor:	Butz M; Heart and Brain Research Group, Kerckhoff Heart and Thorax Centre, Bad Nauheim, Germany.; Department of Neurology, University Hospital Giessen and Marburg, Giessen, Germany.; Department of Geriatrics, Health Centre Wetterau, Schotten, Germany., El-Shazly J; Department of Psychocardiology, Kerckhoff Heart and Thorax Centre, Bad Nauheim, Germany., Gerriets T; Heart and Brain Research Group, Kerckhoff Heart and Thorax Centre, Bad Nauheim, Germany.; Department of Neurology, University Hospital Giessen and Marburg, Giessen, Germany.; Die Neurologen, Private Neurology Practice, Bad Nauheim, Germany., Meyer R; Heart and Brain Research Group, Kerckhoff Heart and Thorax Centre, Bad Nauheim, Germany.; Department of Neurology, University Hospital Giessen and Marburg, Giessen, Germany., Tschernatsch M; Heart and Brain Research Group, Kerckhoff Heart and Thorax Centre, Bad Nauheim, Germany.; Department of Neurology, University Hospital Giessen and Marburg, Giessen, Germany.; Die Neurologen, Private Neurology Practice, Bad Nauheim, Germany., Braun T; Heart and Brain Research Group, Kerckhoff Heart and Thorax Centre, Bad Nauheim, Germany.; Department of Neurology, University Hospital Giessen and Marburg, Giessen, Germany., Schramm P; Heart and Brain Research Group, Kerckhoff Heart and Thorax Centre, Bad Nauheim, Germany.; Department of Neurology, University Hospital Giessen and Marburg, Giessen, Germany., Doeppner TR; Department of Neurology, University Hospital Giessen and Marburg, Giessen, Germany., Gerner ST; Department of Neurology, University Hospital Giessen and Marburg, Giessen, Germany.; Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen, Germany., Boening A; Department of Cardiovascular Surgery, University Hospital Giessen and Marburg, Giessen, Germany., Choi YH; Department of Cardiac Surgery, Kerckhoff Heart and Thorax Centre, Bad Nauheim, Germany., Schoenburg M; Heart and Brain Research Group, Kerckhoff Heart and Thorax Centre, Bad Nauheim, Germany.; Department of Cardiac Surgery, Kerckhoff Heart and Thorax Centre, Bad Nauheim, Germany., Juenemann M; Heart and Brain Research Group, Kerckhoff Heart and Thorax Centre, Bad Nauheim, Germany.; Department of Neurology, University Hospital Giessen and Marburg, Giessen, Germany.
Jazyk:	angličtina
Zdroj:	CJC open [CJC Open] 2023 Nov 15; Vol. 6 (4), pp. 615-623. Date of Electronic Publication: 2023 Nov 15 (Print Publication: 2024).
DOI:	10.1016/j.cjco.2023.11.007
Abstrakt:	Background: Postoperative cognitive decline (POCD) after cardiosurgical interventions are well described through objective psychometric tests. However, a patient's subjective perception is essential to clinical assessment and quality of life. This study systematically evaluated patient-reported POCD between subjects undergoing coronary artery bypass grafting and heart valve replacement. Methods: This study was a multicentre, prospective questionnaire survey conducted at the cardiac surgery departments at the Kerckhoff Clinic in Bad Nauheim and the University Hospital in Giessen, Germany. We included patients undergoing elective coronary artery bypass grafting (CABG), aortic valve replacement (AVR), mitral valve replacement or reconstruction (MVR), and combined surgery (CABG + valve replacement [VR]) with extracorporeal circulation. The Hospital Anxiety and Depression Scale, the Cognitive Failures Questionnaire (CFQ) for Self-assessment (CFQ-S), and the external assessment (CFQ-foreign [F]) were completed preoperatively, as well as at 3 and 12 months postoperatively. Results: A total of 491 patients were available for analyses (CABG = 182, AVR = 134, MVR = 93, CABG + VR = 82). POCD and postoperative depression increase (PODI) were observed for each surgical procedure. (At the 3-month follow-up: CFQ-S [CABG = 7.1%, AVR = 3.7%, MVR = 9.7%, CABG + VR = 9.8%]; CFQ-F [CABG = 9.9%, AVR = 9.7%, MVR = 9.7%, CABG + VR = 15.9%]; PODI [CABG = 7.7%, AVR = 9.7%, MVR = 6.5%, CABG + VR = 8.5%]. At the 12-month follow-up: CFQ-S [CABG = 6.6%, AVR = 7.5%, MVR = 15.1%, CABG + VR = 7.3%]; CFQ-F [CABG = 7.1%, AVR = 14.9%, MVR = 10.8%, CABG + VR = 9.8%]; PODI [CABG = 10.4%, AVR = 11.2%, MVR = 6.5%, CABG + VR = 4.9%]). No significant between-group effects were observed for the CFQ-S, CFQ-F, or the Hospital Anxiety and Depression Scale. Conclusions: For clinicians, paying attention to patients' self-reported experiences of reduced cognitive function and symptoms of depression following cardiac surgery is important. Such reporting is an indication that interventions such as cognitive training or psychotherapy should be considered. (© 2023 The Authors.)
Databáze:	MEDLINE
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