Faculty Collaboration Database

History of post-traumatic stress disorder is associated with impaired neuropsychometric performance after coronary artery surgery. J Cardiothorac Vasc Anesth 2010 Dec;24(6):964-8

Date

05/25/2010

Pubmed ID

20494591

DOI

10.1053/j.jvca.2010.02.019

Scopus ID

2-s2.0-78649528230 (requires institutional sign-in at Scopus site)   17 Citations

Abstract

OBJECTIVE: To determine if preoperative history of post-traumatic stress disorder (PTSD) is associated with postoperative cognitive impairment.

DESIGN: An observational study.

SETTING: Veterans Affairs Medical Center.

PARTICIPANTS: Cardiac surgical patients.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS: Age- 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).

CONCLUSIONS: The 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.

Author List

Hudetz JA, Gandhi SD, Iqbal Z, Patterson KM, Byrne AJ, Warltier DC, Pagel PS

Author

Sweeta D. Gandhi MD Associate Professor in the Anesthesiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Alcoholism
Blood Cell Count
Cardiac Surgical Procedures
Cardiopulmonary Bypass
Cognition Disorders
Coronary Vessels
Depression
Executive Function
Female
Humans
Male
Memory
Mental Recall
Middle Aged
Neurologic Examination
Neuropsychological Tests
Postoperative Complications
Postoperative Period
Stress Disorders, Post-Traumatic
Veterans