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Predictors of cognitive dysfunction after cardiac surgery: A systematic review

Bowden, T. ORCID: 0000-0003-2614-3707, Hurt, C. S., Sanders, J. and Aitken, L. M. (2021). Predictors of cognitive dysfunction after cardiac surgery: A systematic review. European Journal of Cardiovascular Nursing, doi: 10.1093/eurjcn/zvab086

Abstract

Background
Postoperative cognitive dysfunction is often experienced by cardiac surgery patients, however it is not known if some groups of patients experience this more frequently or severely than others.

Aims
The aim of this systematic review was to identify preoperative and postoperative predictors of cognitive dysfunction in adults following cardiac surgery.

Methods
Eight bibliographic databases were searched (January 2005 to March 2021) in relation to cardiac surgery and cognition. Studies including adult patients who had undergone open cardiac surgery and using a validated measurement of cognitive function were included. Full-text review for inclusion, quality assessment, and data extraction were undertaken independently by two authors.

Results
A total of 2870 papers were identified, of which 36 papers met the inclusion criteria and were included in the review. The majority were prospective observational studies (n=28 [75.7%]). In total, 61 independent predictors (45 preoperative and 16 postoperative) were identified as significant in at least one study; advancing age and education level appear important. Age has emerged as the most common predictor of cognitive outcome.

Conclusion
Although a number of predictors of postoperative cognitive dysfunction have been identified, they have inconsistently been reported as significantly affecting cognitive outcome. Consistent with previous research, our findings indicate that older patients and those with lower educational levels should be prioritised when developing and trialling interventions to improve cognitive function. These findings are less than surprising if we consider the methodological shortcomings of included studies. It is evident that further high-quality research exploring predictors of POCD is required.

Publication Type: Article
Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in European Journal of Cardiovascular Nursing following peer review. The version of record, Predictors of cognitive dysfunction after cardiac surgery: A systematic review. European Journal of Cardiovascular Nursing, will be available online at: https://academic.oup.com/eurjcn
Publisher Keywords: cardiac surgical procedures; cognitive dysfunction; predictor
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RC Internal medicine
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Departments: School of Health Sciences > Nursing
Date available in CRO: 27 Sep 2021 10:03
Date deposited: 27 September 2021
Date of acceptance: 31 August 2021
URI: https://openaccess.city.ac.uk/id/eprint/26801
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