Assessment of long‐term mild and major neurocognitive disorders 48 months after cardiac surgery

Abstract

Objectives To assess the incidence of both Mild and Major Neurocognitive Disorders (NCD), according to the DSM-5 criteria, after cardiac surgery (off-pump an on-pump procedures) and to propose some risk associated factors. Methods Prospective and sequential study. Patients (n = 70, 65.9 years old, mean age) were evaluated for cognitive function (Neuronorma Battery) and daily life activities (Barthel Index and Bayer-Activities of Daily Living Scale) before surgery and at 1, 6, 12, and 48 months postoperatively. Off-pump (n = 36) and on-pump (n = 34) patients groups were compared. DSM-5 criteria for Mild NCD and Major NCD were applied. Independent associated risk factors were described. Results A 40.8% (off-pump) and 39.3% (on-pump) of patients met DSM-5 criteria for Mild NCD 48 months after cardiac surgery and a further 7.1% (on-pump) of them, for Major NCD. Clinical factors were associated with Mild NCD and both clinical and surgical factors, were associated with Major NCD. Conclusion A relevant incidence of long-term Mild NCD and Major NCD has been described 48 months after cardiac surgery, more intense in the on-pump group of patients. Assessment (identifying those with higher risk), prevention and treatment strategies for these patients should be provided. The DSM-5 criteria to classify NCD could be applied to characterize any cognitive decline due to any disease or surgical procedure.