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Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva
Minerva Anestesiologica 2009 May;75(5):329-32
Cognitive dysfunction after cardiovascular surgery
Funder K. S., Steinmetz J., Rasmussen L. S.
Department of Anesthesia, Center of Head and Orthopedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
This review describes the incidence, risk factors, and long-term consequences of cognitive dysfunction after cardiovascular surgery. Postoperative cognitive dysfunction (POCD) is increasingly being recognized as an important complication, especially in the elderly. A highly sensitive neuropsychological test battery must be used to detect POCD and a well-matched control group is very useful for the analysis and interpretation of the test results. Cardiovascular surgery is associated with a high incidence of POCD. Cardiopulmonary bypass was thought to explain this difference, but randomized studies comparing with off-pump coronary artery bypass surgery show contradictory results. POCD seems to have important long-term consequences regarding self-assessed quality of life, survival, and labor market attachment.