Abstract
Background and Goal of Study:
After cardiac surgery many patients experience postoperative cognitive dysfunction (POCD), usually comprising impaired concentration, attention, working memory and executive function. These sometimes subtle defects are usually assessed by neuropsychological examination, but this is time-consuming and associated with relatively high rates of non-compliance or completion caused by fatigue or impaired attention intrinsic to the disorder. We are studying POCD in patients undergoing cardiac surgery using a newer set of computerized tests (Cogstate, Australia) that may be more sensitive to detect cognitive decline than paper-and-pencil tests1. We present here an interim analysis of compliance with this test battery.
Materials and Methods:
In this ethical committee approved study, cognitive function before and after coronary artery revascularization was assessed in consenting patients using the CogState battery of tests. Assessments take the form of card games, which makes them culture-neutral and independent of educational level. The following 4 tasks were used: 1) detection task, 2) identification task, 3) one card learning task, and 4) one back task, assessing reaction time, psychomotor function, working memory, and attention respectively. POCD was defined as a composite score decrease of more than 2 Z-scores, or by a standardized change score decrease of ≥2 Z-scores in ≥2 tasks.
Results and Discussion:
We have included 32 patients so far. The incidence of POCD after 5.3 ± 2.1 days was 45%. All patients were able to perform detection and identification tasks after surgery. One did not complete the one card learning task and one back task. This patient fulfilled the criteria for POCDbased on the first 2 tasks. We estimate that the tests took on average 15 minutesin total to complete. In our experience so far, test compliance is 97-100%,similar to that reported by Padmanabhan (97-99%)2. Paper-and-pencil testshave a lower compliance record - Rasmussen reported a mean rate of 83.9% in a review of 13 studies3.
Conclusion(s):
We conclude that in addition to being a highly sensitive tool toestablish POCD, the CogState test battery is quick to perform, and associatedwith high compliance rates.
References:
1. Ichimura S et al. Neurol Med Chir (Tokyo) 2010;50:441-8
2. Padmanabhan U et al. Anesth Analg 2009;109:1448-55
3. Rasmussen LS et al. Acta Anaesthesiol Scand 2001;45:275-89
After cardiac surgery many patients experience postoperative cognitive dysfunction (POCD), usually comprising impaired concentration, attention, working memory and executive function. These sometimes subtle defects are usually assessed by neuropsychological examination, but this is time-consuming and associated with relatively high rates of non-compliance or completion caused by fatigue or impaired attention intrinsic to the disorder. We are studying POCD in patients undergoing cardiac surgery using a newer set of computerized tests (Cogstate, Australia) that may be more sensitive to detect cognitive decline than paper-and-pencil tests1. We present here an interim analysis of compliance with this test battery.
Materials and Methods:
In this ethical committee approved study, cognitive function before and after coronary artery revascularization was assessed in consenting patients using the CogState battery of tests. Assessments take the form of card games, which makes them culture-neutral and independent of educational level. The following 4 tasks were used: 1) detection task, 2) identification task, 3) one card learning task, and 4) one back task, assessing reaction time, psychomotor function, working memory, and attention respectively. POCD was defined as a composite score decrease of more than 2 Z-scores, or by a standardized change score decrease of ≥2 Z-scores in ≥2 tasks.
Results and Discussion:
We have included 32 patients so far. The incidence of POCD after 5.3 ± 2.1 days was 45%. All patients were able to perform detection and identification tasks after surgery. One did not complete the one card learning task and one back task. This patient fulfilled the criteria for POCDbased on the first 2 tasks. We estimate that the tests took on average 15 minutesin total to complete. In our experience so far, test compliance is 97-100%,similar to that reported by Padmanabhan (97-99%)2. Paper-and-pencil testshave a lower compliance record - Rasmussen reported a mean rate of 83.9% in a review of 13 studies3.
Conclusion(s):
We conclude that in addition to being a highly sensitive tool toestablish POCD, the CogState test battery is quick to perform, and associatedwith high compliance rates.
References:
1. Ichimura S et al. Neurol Med Chir (Tokyo) 2010;50:441-8
2. Padmanabhan U et al. Anesth Analg 2009;109:1448-55
3. Rasmussen LS et al. Acta Anaesthesiol Scand 2001;45:275-89
| Original language | English |
|---|---|
| Article number | 7AP4-9 |
| Pages (from-to) | 113-114 |
| Number of pages | 2 |
| Journal | European Journal of Anaesthesiology |
| Volume | volume 29 |
| Issue number | supplement 50 |
| DOIs | |
| Publication status | Published - 11-Jun-2012 |
| Event | Euroanaesthesia 2012 - Paris, France Duration: 9-Jun-2012 → 12-Jun-2012 |