Alteraciones neurocognitivas y emocionales en pacientes mayores de 60 años sometidos a cirugía cardiaca Fundación Cardioinfantil (estudio piloto)

Abstract

Objective. Neurocognitive alterations are one of the most important complications after cardiac surgery, with a highly variable frequency of presentation, given the demographic differences that occur within the population being managed, given by age, gender, socioeconomic status, degree of schooling and type of procedure, with a presentation rate that also varies according to the time that is assessed after cardiac surgery, for which the present study is proposed to describe the frequency of neurocognitive and emotional alterations in patients over 65 years of age. short-term cardiac surgery. Method: A sample of 30 patients electively scheduled for cardiac surgery will be taken who will undergo three types of tests for cognitive assessment (MoCA test), emotional state as well as depressive (Beck's depression scale) and anxiety (evaluation of state of anxiety - STAI trait) at three different times, time 0 the day before surgery; time 1, 5 to 7 days after surgery and time 2, 3 to 4 weeks after surgery. They will be analyzed according to cut-off points established for this type of population in each test performed and analysis of each test in a comparative way over time. Results: A total of 30 patients, after signing consent, completed the 3 tests in the three moments described, in the MoCA test a score with a mean of 24.3 was obtained at time 0, with evidence of a tendency to increase the mean in the time 2, with a score of 25.9 that can be seen facilitated by learning and repeating the same test, with 6.6% of the population 6 assessed. In the depression scale test, a mean of 13.1 was observed at time zero and 11.6 at time 2, with no evidence of an increase or decrease trend in the average score, with 40% of patients with an unsatisfactory test at time zero compared with 41.3% of patients with unsatisfactory test at time 2, and in the anxiety test an average of 39.3% was observed at time zero and 35% at time 2. Discussion: the frequency evidenced of the population with neurocognitive alterations in the postoperative period was 6.6% within the population managed in the Cardioinfantil foundation, which can be biased by the short-term repetition of the same test, without being able to determine long-term alterations term. Being more evident the great variation in the degree of education, which is important at the time of qualifying the test and being able to determine as satisfactory or not according to the cut-off point. An important component of depression and anxiety is evidenced by the scores obtained in each test, which is compatible with the emotional process that a patient undergoes in a perioperative cardiac surgery. Without showing important changes in the results in the postoperative period compared to the baseline tests at time zero. The importance of a more objective assessment through psychological tests to complement the neurological assessment and follow-up of these patients in the postoperative period is highlighted.