Analysis of the perioperative change in cognitive function of patients with risk factors for cognitive impairment in cardiovascular surgery

Abstract

Although preoperative cognitive decline and patients' age were the risk factors for early postoperative cognitive impairment after CVS, a significant recovery can be expected even in elderly patients or patients with low preoperative cognitive function by the time of discharge.

Dementia and Cognitive Impairment on Coronary Artery Bypass Grafting Patients in Aging Society

“…In the ROOBY trial, preoperative baseline cognitive analyses were performed, and more than 20% of patients showed MCI. Additionally in this study, less than 10% of patients were diagnosed as dementia at baseline 29) , which was similar to the reported ratio of dementia in the study by Yoshimoto and our own institution 22,28) . Silbert et al reported that some cognitive impairment was presented in ap-…”

“…The highest rates of POCD (approximately 50% of patients) have been observed in the early weeks, followed by a significant reduction in incidence over the first 6 months 37,38) . The risk factors occurring POCD have been analyzed, and preoperative cognitive decline, older age were found to be predictive factors for POCD 28,29) .…”

Cognitive assessment using the revised Hasegawa's dementia scale to determine the mid-term outcomes following transcatheter aortic valve replacement

“…Patients with HDS-R 23 actually had longer intensive care unit and hospital stays despite similar procedural complication rates between the two groups, although there is a lack of information regarding postprocedural cognitive impairment. Conversely, in a previous study showing the association between TAVR and the mini-Mental State Examination (MMSE), the best cut-off point of the MMSE for predicting mortality following TAVR was 25, which is almost equivalent to a score of 23 in the HDS-R [5,11]. Although it remains unclear as to which tests work better in the TAVR population, the HDS-R may be superior to the MMSE as a cognitive screening test in terms of the measure for memory [16,17].…”

“…Although patients with HDS-R 20 were considered to have dementia by definition, the HDS-R scores were dichotomized into two groups (HDS-R 23 and >23) according to the best cut-off point in the receiver operating characteristic (ROC) analysis for allcause mortality at 3 years in the present study [5,10]. Kaplan-Meier analysis was used to estimate the cumulative mortality in each group.…”

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Over the past few decades, transcatheter aortic valve replacement (TAVR) has emerged as a less invasive alternative to surgical aortic valve replacement [1][2][3]. Although there was a tremendous survival advantage and symptom benefit for many patients undergoing TAVR, compared with medical therapy, some patients died soon after the procedures [4,5]. Recently, variable frailty markers have been developed to guide better patient selection and are considered to be essential components of patient care in TAVR [6][7][8][9].The revised Hasegawa's dementia scale (HDS-R), which is composed of nine simple questions, was initially developed in

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