Preoperative Cognitive Impairment and Cardiac Surgery

Cognitive impairment in the surgical patient may have a significant impact on their postoperative outcome. Cardiac surgical procedures with their inherent neurocognitive risks add a layer of complexity in patients with preexisting disorders of cognition. Authors in this issue of Anesthesia & Analgesia explored the relationship between preoperative cognitive impairment in cardiac surgical patients and postoperative outcomes. A meta-analysis by Au and colleagues analyzed 16 studies incorporating over sixty thousand patients over the age of 60. Those patients with preoperative cognitive impairment were found to have statistically higher rates of postoperative delirium after cardiac surgery. In addition, their length of stay was significantly longer and a higher rate of postoperative bleeding was also noted. No increase in 30-day mortality was seen in this study. Increased efforts aimed at identifying preoperative cognitive impairment may help risk stratify patients who are at higher risk of postoperative complications after cardiac procedures. The reader is strongly encouraged to review the cited article for an in-depth understanding of the concepts summarized in this infographic.