D-30Internet-based Assessment of Post-Operative Neurocognitive Function in Cardiac and Thoracic Aortic Surgery Patients

Objective: The aim of this study was to examine long-term neurocognitive function in patients who underwent cardiac or thoracic aortic surgery with varying periods of cardiopulmonary bypass (CPB), hypothermic circulatory arrest (HCA), and selective cerebral perfusion (SCP) in the past 6 years. Method: Patients who had undergone procedures with CPB (n = 207), CPB with HCA (n = 67), or CPB with HCA and SCP (n = 26) were administered the Cognitive Stability Index HeadMinder^® battery to assess response speed, processing speed, memory, and attention factor scores. Multiple linear regression modeled associations among CPB, HCA, and SCP times and factor scores, controlling for standard covariates: age, gender, educational status, and time since surgery. Non-linear relationships were tested by quadratic polynomial terms. Results: CPB and SCP durations were unrelated to any of the factor scores. HCA duration was negatively associated with processing speed scores and memory scores; for any 10-min increase in exposure to HCA, the processing speed and memory z-scores were reduced by .64 and .70, respectively. Attention scores demonstrated a similar non-significant trend; for any 10-min increase in exposure to HCA, the z-score was reduced by .36 (p = .09). There was a non-significant trend for a non-linear association between HCA duration and response speed (p = .07); beyond 24 min, for any 10-min increase in HCA time, the response speed z-score was reduced by .81. Conclusion: Despite the limitation of not assessing baseline function, these preliminary data support the hypothesis that HCA >24 min is associated with poorer neurocognitive outcomes and demonstrate the efficacy of remote Internet-based post-operative cognitive assessment.

NEUROLOGICAL AND NEUROPSYCHIATRIC DISORDERS: TRAUMATIC BRAIN INJURY