Neuropsychologic testing within 18 hours after cardiac surgery.

ABSTRACT

OBJECTIVE: To undertake neuropsychologic testing within 18 hours of cardiac surgery after fast-track anesthesia. DESIGN: Prospective study. SETTING: University hospital, single center. PARTICIPANTS: Fifty patients undergoing first-time elective coronary artery surgery. INTERVENTIONS: A neuropsychologic test battery was administered preoperatively and 18 hours and 5 days after surgery. MAIN RESULTS: Seven patients were withdrawn, and 9 patients did not attempt the postoperative tests (on both occasions) because of medical complications. Thirty patients completed > or =4 tests at both postoperative occasions. Of these, 9 patients (30%) showed a deficit in > or =2 tests at 18 hours postoperatively, and 3 (10%) showed a deficit at 5 days postoperatively. CONCLUSION: In the absence of medical complications and despite the difficulties, early postoperative neuropsychologic testing is possible after fast-track anesthesia. Such testing has the potential to more clearly define the course of cognitive decline after cardiac surgery.