• Judith A Hudetz, Sweeta D Gandhi, Zafar Iqbal, Kathleen M Patterson, Alison J Byrne, David C Warltier, and Paul S Pagel.
• Department of Anesthesiology, Medical College of Wisconsin and Clement J Zablocki Veterans Administration Medical Center, Milwaukee, WI 53295, USA. judith.hudetz@va.gov
• J. Cardiothorac. Vasc. Anesth. 2010 Dec 1;24(6):964-8.

ObjectiveTo determine if preoperative history of post-traumatic stress disorder (PTSD) is associated with postoperative cognitive impairment.DesignAn observational study.SettingVeterans Affairs Medical Center.ParticipantsCardiac surgical patients.InterventionsNone.Measurements And Main ResultsAge- and education-balanced patients (≥55 years of age) undergoing cardiac surgery (n = 30 with a history of PTSD+, n = 56 without a history of PTSD-) and nonsurgical controls (n = 28) were recruited. Recent verbal and nonverbal memory and executive functions were assessed before and 1 week after cardiac surgery or at 1-week intervals in nonsurgical controls. Demographic and medical parameters were similar between groups with the exception of preoperative depression and a history of alcohol dependence. Preoperative depression scores were significantly (p = 0.02) higher in PTSD+ compared with PTSD- groups. Immediate Word List Recall and Delayed Word List Recall under baseline conditions were worse in PTSD+ compared with PTSD- patients. Cognitive performance after surgery decreased by at least 1 standard deviation in 27 PTSD- patients (48%) and in 25 PTSD+ patients (83%) (p = 0.002) versus nonsurgical controls. Multivariate regression analysis (including a history of depression and alcohol dependence) revealed that a history of PTSD was significantly associated with overall (including nonverbal recent memory, verbal recent memory, and executive functions) postoperative cognitive dysfunction (p = 0.005).ConclusionsThe current findings suggest that patients with a history of PTSD undergoing coronary artery surgery using cardiopulmonary bypass may be especially vulnerable to postoperative cognitive impairment.Copyright © 2010 Elsevier Inc. All rights reserved.

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