Document Detail


Diabetes mellitus increases adverse neurocognitive outcome after coronary artery bypass grafting surgery.
MedLine Citation:
PMID:  16902877     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cognitive dysfunction is a well known problem in the postoperative period in cardiac surgery. We hypothesised that the incidence of postoperative cognitive dysfunction in patients with diabetes mellitus is higher than in the nondiabetic patient. METHODS: Thirty-four patients (11 females, 23 males) with a mean age of 62.44 +/- 7.52 undergoing on-pump CABG surgery were studied in a prospective manner. Fourteen patients had treated diabetes mellitus (Group I) and 20 were nondiabetic (Group II). All patients were operated upon by the same surgeon under standardised intra- and perioperative conditions. Patients with preoperative dementia (MMSE < 24) or advanced cerebrovascular disease were excluded. An extensive set of tests examining emotional and cognitive state, stress-coping and quality of life were performed preoperatively. Emotional and cognitive variables were assessed daily from day two to five postoperatively. RESULTS: All tests showed comparable results between the groups preoperatively. The perfusion lasted considerably longer in Group I (102.5 +/- 16.61 vs. 83.9 +/- 14.1 min) as did the cross clamping (64.21 +/- 18.31 vs. 51.75 +/- 10.88 min). Postoperative cognitive outcome was significantly worse in Group I with regard to the Stroop Test (29.46 +/- 8.6 vs. 24.01 +/- 6.23, P = 0.02), the Abbreviated Mental Test (8.04 +/- 0.71 vs. 8.68 +/- 0.78, P = 0.02) and the Trial Making Test (35.72 +/- 11.38 vs. 29.3 +/- 7.77 P = 0.04). These differences persisted even after adjustment for perfusion- and cross-clamping time. CONCLUSION: The cognitive outcome in the early postoperative period is worse in diabetic patients compared to nondiabetics. Speed-related cognitive functions are mainly affected. Probably, this reflects a different physiology of cerebral perfusion during extracorporeal circulation. Optimising perfusion strategies to improve the outcome of diabetic patients should be the next topic of study.
Authors:
A Nötzold; K Michel; A A Khattab; H H Sievers; M Hüppe
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Thoracic and cardiovascular surgeon     Volume:  54     ISSN:  0171-6425     ISO Abbreviation:  Thorac Cardiovasc Surg     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-11     Completed Date:  2006-12-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903387     Medline TA:  Thorac Cardiovasc Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  307-12     Citation Subset:  IM    
Affiliation:
Department for Cardiac Surgery, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany. axel.noetzold@segebergerkliniken.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Case-Control Studies
Cognition Disorders / epidemiology,  etiology*,  physiopathology
Coronary Artery Bypass / adverse effects*
Diabetes Complications / epidemiology*,  physiopathology
Diabetes Mellitus, Type 1 / complications*,  physiopathology
Diabetes Mellitus, Type 2 / complications*,  physiopathology
Female
Humans
Incidence
Male
Middle Aged
Neuropsychological Tests
Postoperative Complications / etiology*,  physiopathology
Psychometrics
Psychomotor Performance
Quality of Life
Research Design
Severity of Illness Index
Sickness Impact Profile
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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