caa a22 4500 445373520 CHVBK 20180317142955.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1007/s00540-011-1108-5 doi (NATIONALLICENCE)springer-10.1007/s00540-011-1108-5 Impaired cognition preceding cardiac surgery is related to cerebral ischemic lesions [Elektronische Daten] [Kengo Maekawa, Tomoko Goto, Tomoko Baba, Atsushi Yoshitake, Kazuhiro Katahira, Tatsuo Yamamoto] Purpose: Cognitive dysfunction is more frequent after cardiac surgery. However, the preoperative cognitive state is seldom assessed when the effects of cardiac surgery on cognition are investigated. Postoperative cognitive dysfunction may be associated with the preoperative cognitive state and the existence of cerebral ischemic lesions in patients who undergo cardiac surgery. Methods: Data were collected prospectively on 362 consecutive patients scheduled to undergo elective cardiac surgery. The brains of all patients were imaged by magnetic resonance imaging (MRI) to assess prior cerebral infarctions, carotid artery stenosis and intracranial arterial stenosis, and diffusion-weighted imaging (DWI) was used to assess acute cerebral ischemia. Patients were classified with impaired cognitive function prior to surgery if their score on the Hasegawa dementia rating scale was <24. Postoperative cognitive dysfunction from baseline was determined using four neuropsychological tests. Results: Prior to surgery 40 patients (11%) were assessed with impaired cognition. Relative to the other patients, these patients were older and less well educated, and they had significantly higher rates of peripheral vascular disease, white matter lesions, cerebral infarction on MRI, carotid artery stenosis and postoperative cognitive dysfunction. Of these 40 cognitively impaired patients, seven (18%) had cerebral ischemia, based on DWI images before surgery; in comparison, nine of the 322 patients (3%) without preoperative cognitive impairment were found to have abnormalities on the DWI images (P<0.001). An analysis by stepwise logistic regression demonstrated that the significant risks for preoperative cognitive impairment were advanced age, lower attained level of education, peripheral artery disease, prior cerebral infarctions, and abnormalities on DWI images. Conclusions: These findings suggest that preoperative cognitive impairment associated with cerebral ischemic lesions and an increased risk of postoperative cognitive dysfunction existed in our patient cohort undergoing cardiac surgery. Japanese Society of Anesthesiologists, 2011 Cardiac surgery nationallicence Cerebral ischemia nationallicence Magnetic resonance imaging nationallicence Cognition nationallicence Maekawa Kengo Departments of Anesthesiology and Radiology, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, 862-0965, Kumamoto, Japan aut Goto Tomoko Departments of Anesthesiology and Radiology, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, 862-0965, Kumamoto, Japan aut Baba Tomoko Departments of Anesthesiology and Radiology, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, 862-0965, Kumamoto, Japan aut Yoshitake Atsushi Departments of Anesthesiology and Radiology, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, 862-0965, Kumamoto, Japan aut Katahira Kazuhiro Departments of Anesthesiology and Radiology, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, 862-0965, Kumamoto, Japan aut Yamamoto Tatsuo Department of Anesthesiology, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan aut Journal of Anesthesia Springer Japan 25/3(2011-06-01), 330-336 0913-8668 25:3<330 2011 25 540 https://doi.org/10.1007/s00540-011-1108-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00540-011-1108-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Maekawa Kengo Departments of Anesthesiology and Radiology, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, 862-0965, Kumamoto, Japan aut NATIONALLICENCE 700 1- Goto Tomoko Departments of Anesthesiology and Radiology, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, 862-0965, Kumamoto, Japan aut NATIONALLICENCE 700 1- Baba Tomoko Departments of Anesthesiology and Radiology, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, 862-0965, Kumamoto, Japan aut NATIONALLICENCE 700 1- Yoshitake Atsushi Departments of Anesthesiology and Radiology, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, 862-0965, Kumamoto, Japan aut NATIONALLICENCE 700 1- Katahira Kazuhiro Departments of Anesthesiology and Radiology, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, 862-0965, Kumamoto, Japan aut NATIONALLICENCE 700 1- Yamamoto Tatsuo Department of Anesthesiology, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan aut NATIONALLICENCE 773 0- Journal of Anesthesia Springer Japan 25/3(2011-06-01), 330-336 0913-8668 25:3<330 2011 25 540 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer