CEREBRAL-DYSFUNCTION AFTER CARDIAC OPERATIONS IN ELDERLY PATIENTS

Background. Cerebral injury remains a significant complication of card iac operations. We determined the incidence of cerebral dysfunction in a population of elderly patients undergoing open chamber cardiac oper ations (group 1) as compared with a younger population (group 2) and a n age-matched group of elderly patients undergoing major noncardiac op erations (group 3). Methods. Sixty-eight patients (55 for open chamber cardiac operations and 13 for noncardiac operations) were prospective ly studied. Patients were evaluated preoperatively and postoperatively before hospital discharge using a complete neurologic examination and a battery of standard neuropsychometric tests, and at surgical follow -up with neuropsychometric tests only. Results. Postoperative changes detected by neurologic examination consisted of the appearance of new primitive reflexes in all groups. No statistically significant differe nces in incidence were found. The neuropsychometric performance of gro up 1 patients was statistically different from that of patients in gro ups 2 and 3 only in the early follow-up period. Conclusions. Elderly p atients having open chamber cardiac operations exhibit significantly m ore cerebral dysfunction in the early postoperative period than those undergoing major noncardiac operations and younger patients after open chamber procedures. These changes do not persist into the late follow -up period.