• Shahriar Shayan, Obianuju Okocha, Nina Srdanovic, Lauren Balmert, Jordan Grafman, Ashwin S Madhan, Sahej S Samra, Iv Charles H Brown, BobbieJean Sweitzer, and Charles W Hogue.
• Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL.
• J. Cardiothorac. Vasc. Anesth. 2022 Apr 1; 36 (4): 1056-1063.

ObjectivesTo evaluate whether there is a relationship between preoperative anemia and domain-specific cognitive performance in patients undergoing cardiac surgery.DesignRetrospective analysis of data collected from a randomized study.SettingTertiary care university hospital.ParticipantsA total of 436 patients age ≥55 years undergoing cardiac surgery.InterventionNone.Measurements And Main ResultsNeuropsychological testing was performed before and one month after surgery, using a standard battery. Individual Z-scores calculated from the mean and standard deviation of tests at baseline were combined into domain-specific scores. Anemia (hemoglobin <130 g/L for men, <120 g/L for women) was present in 41% of patients. Preoperative anemia had little impact on preoperative cognition. There were no differences in the change in cognitive performance one month after surgery from baseline between patients with and without preoperative anemia. However, in a sensitivity analysis using multiple imputation for missing cognitive test scores, significant associations were observed between preoperative anemia and change in postoperative processing speed (p = 0.016), change in executive function (p = 0.049), and change in fine motor speed (p = 0.016). Nadir hemoglobin during cardiopulmonary bypass, which was lower in anemic than nonanemic patients, was associated with decrements in performance on tests of verbal fluency (p = 0.007), processing speed (p = 0.042), and executive function (p = 0.10) one month after surgery but not delayed neurocognitive recovery (p = 0.06).ConclusionsPreoperative anemia may be associated with impairment of selective cognitive domains after surgery. Any effect of preoperative anemia may have on cognition after surgery might be related to lower nadir hemoglobin during cardiopulmonary bypass.Copyright © 2021. Published by Elsevier Inc.

21 keywords...

hide…