Features of cognitive disorders in patients with different forms of neurological and ischemic complications who underwent cardiac surgery

Abstract

Objective — to study the features of cognitive impairment in patients with various forms of neurological and ischemic complications who underwent cardiac surgery (CS), to consider the data obtained in the development of rehabilitation programs for this category of patients. Methods and subjects. We examined 700 patients who were treated at the Heart Institute of the Ministry of Health of Ukraine after undergoing CS with an artificial circulation procedure. The sample size is extremely large, and makes it possible to transfer the results to the entire population of patients who have suffered from CS. Among the examined patients the following groups were identified: a) patients with cerebral infarction (CI) in the postoperative period, numbering 86 people, the performance of patients in this group was compared with patients with CS without myocardial infarction in the postoperative period, numbering 614 people taken from the same sample); b) patients with signs of postoperative encephalopathy, numbering 217 people (which included patients with CI). The performance of patients in this group was compared with that of 483 patients with CS without signs of postoperative encephalopathy, taken from the same sample. The study was conducted using the Trail Making Test, TMT (R. M. Reitan, Wolfson D., 1993); Verbal Fluency Test, VFT (M. D. Lezak, 1995); Stroop Color Interference Test (J. R. Stroop, 1935); Luria’s test for memorizing ten unrelated words (Luria AR, 1969). Statistical analysis of differences in the quantitative values of indicators was performed using the nonparametric Mann‑Whitney test. Results. Our study found significant cognitive impairment in patients with CS. It was found that the presence of ischemic and neurological complications in the postoperative period significantly impairs cognitive function. The most significant negative impact on the cognitive sphere has the presence of CI in the postoperative period: patients with CI showed signs of severe cognitive deficits. Manifestations of cognitive deficits were also found in patients with postoperative encephalopathy, although the quantitative indicators characterizing cognitive functioning in this group of patients were better than in patients with CI. Conclusions. The identified patterns should be taken into account when developing treatment, rehabilitation and preventive measures for patients with CS.