Assessment Of Risk Factors for Postoperative Cognitive Dysfunction After Coronary Artery Bypass Surgery

Abstract

Background: Coronary artery bypass graft (CABG) surgery is a widely performed procedure and the gold standard for treating advanced coronary artery disease. Despite advances reducing mortality, postoperative complications remain a concern, especially in aging patients with comorbidities. Postoperative cognitive dysfunction (POCD) is a common complication characterized by impairments in memory, attention, and executive function. POCD can significantly impact patients’ quality of life and functional independence long after surgery.

Aim and Objective: To assess the prevalence of postoperative cognitive dysfunction (POCD) in coronary artery bypass grafting patients.

Material and Methods: A cross-sectional study was conducted at Khyber Teaching Hospital Peshawar with 180 participants predominantly male (93.9%) and aged over 50 years (74.4%). Data on demographic characteristics, health status, anesthesia duration, and postoperative complications were collected and analyzed. The Montreal Cognitive Assessment (MOCA) was used to evaluate cognitive function post-surgery.

Result: A total of 180 participants, mostly males (93.9%) aged over 50 years (74.4%), were included. Half reported diabetes (50%) and smoking (50%), with 62.2% experiencing anesthesia longer than three hours. Postoperative complications included prolonged hospitalization (37.8%) and reintubation (37.2%). Montreal Cognitive Assessment showed significant impairment in memory recall and attention, with longer anesthesia duration strongly associated with decreased cognitive performance (p < 0.001).

Conclusion: Postoperative cognitive dysfunction is a common complication following coronary artery bypass graft surgery, particularly among older male patients with comorbidities such as diabetes and history of smoking. Prolonged anesthesia significantly correlates with impairments in memory recall and attention. Early identification and management of risk factors may help reduce the incidence and impact of cognitive decline after surgery, improving patient outcomes and quality of life.