• K P Grichnik, A J Ijsselmuiden, T A D'Amico, D H Harpole, W D White, J A Blumenthal, and M F Newman.
• Department of Anesthesia, Duke University Medical Center, Durham, North Carolina 27710, USA. grich002@mc.duke.edu
• Ann. Thorac. Surg. 1999 Nov 1; 68 (5): 1786-91.

BackgroundCardiac operations frequently are complicated by postoperative cognitive decline. Less common and less studied is postoperative cognitive decline after noncardiac surgery, so we determined its incidence, severity, and possible predictors.MethodsTwenty-nine patients who had thoracic and vascular procedures were studied. A neurocognitive test battery was administered preoperatively and 6 to 12 weeks postoperatively. A change score (preoperative minus postoperative) was calculated for each measure in each individual. Cognitive deficit (a measure of incidence) was defined as a 20% decrement in 20% or more of the completed tests. The average scores of all tests and the average decline (a measure of severity) were determined.ResultsThe incidence of cognitive deficit was 44.8%. Overall the severity of the decline was an average of 15% decline. In the 44.8% of patients who had cognitive deficit, the severity was 24.7%. Multivariable predictors of cognitive decline were age (for incidence and severity) and years of education (for severity).ConclusionsCognitive decline after noncardiac operations is a frequent complication of surgical procedures. The severity could preclude successful return to a preoperative lifestyle.

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