Risk factors of postoperative cognitive dysfunction in patients of acute type A aortic dissection

Ma Wenjian; Li Xiaoqing; Bi Qi

doi:10.3760/cma.j.issn.1673-4777.2015.05.010

Abstract：Objective To investigate the risk factors of postoperative cognitive dysfunction (POCD) in patients of acute type A aortic dissection.Methods One hundred and sixty-eight patients of acute type A aortic dissection who underwent selective antegrade cerebral perfusion under deep hypothermic circulatory arrest from August 2011 to July 2014 were collected.The general data and past history of the patients were recorded before operation.Before and 14 days after operation,the nervous and cognitive function were assessed using minimum mental state examination (MMSE) and Montreal cognitive assessment (MoCA) to diagnose POCD,and then the patients were divided into POCD group (56 cases) and non-POCD group (112 cases).The risk factors of POCD were analyzed.Results The total incidence of POCD was 33.3％ (56/168).The rates of previous cerebrovascular disease history and hypertension in POCD group were significant higher than those in non-POCD group [60.7％ (34/ 56) vs 35.7％ (40/112),92.9％ (52/56) vs 89.3％ (100/112),P ＜ 0.05].The scores of cognitive function including the visual space and execution,depending on-named ability,attention,language ability,abstract ability,delayed memory ability and directional power ability in POCD group were significantly lower than those in nonPOCD group [(2.78 ± 1.52) scores vs (4.45 ± 0.71) scores,(2.51 ± 0.24) scores vs (2.96 ± 0.43) scores,(3.97 ± 1.69) scores vs (5.86 ± 0.51) scores,(1.78 ± 0.29) scores vs (2.46 ± 0.63) scores,(0.95 ± 0.87) scores vs (1.95 ±0.93) scores,(1.79 ± 1.22) scores vs (4.12 ±0.14) scores,(5.19 ±0.24) scores vs (5.92 ±0.17) scores] (P ＜0.05).Conclusion Previous cerebrovascular disease history and hypertension are independent risk factors of POCD in patients of acute type A aortic dissection after surgery.