An Investigation Of Cognitive Dysfunction And Its Influential Factors Among The Patients Following Coronary Artery Bypass Grafting

Objective:To investigate the status of cognitive dysfunction among the patients following coronary artery bypass grafting, and the relationship among preoperative mental state, personality traits and social support. To explore the predictors of postoperative cognitive dysfunction, and provide a reference basis to adopt intervention, reduce the occurrence and improve the prognosis.Methods:Subjects were selected from a convenience sample from a class 3-A comprehensive hospital with coronary artery bypass grafting. We used questionnaire package included general characteristics questionnaire, Self-reporting Inventory (SCL-90), Neuroticism Extraversion Openness Five-Factor Inventory (NEO-FFI), Social Support Rating Scale (SSRS) and Minimum Mental State Examination (MMSE).Data were processed by SPSS 19.0, including descriptive analysis, chi-square test, t-test, univariate analyses and multiple stepwise regression analysis.Results:1.A total of 120 patients were investigated and 103 (85.8%) effective questionnaire have been got. Among them 58 were men and 45were women. The age of patients was 28-78, the average age was (61.3±9.03), education was given to technical secondary school or high school, operating time was for (180-410) minutes, the average time was (272.3±44.70) minutes, patients stayed in the intensive care unit (ICU) for (32-186) hours, the average time was (80.47±25.74)hours. There were 30 patients used dexmedetomidine after the operation, and 40 patients with extracorporeal circulation in the operation.2. The MMSE scores was (21-30) for patients after operation, the average scores was27.3,26 patients scores were less than 27, so we considered has a postoperative cognitive dysfunction, the prevalence was 25.2%.3. Results of the univariate analysis showed that there remained significant differences inpatients’age, extracorporeal circulation, the use of sedatives, operation time, time of stayed in the intensive care, sensitivity of interpersonal relationship, anxiety, nervousness, extraversion, conscientiousness, subjective support and exploitation of social support (P< 0.05).4. Multiple stepwise regression analysis found that patients’age, operation time, sensitivity of interpersonal relationship, neuroticism and exploitation of social support can predict the incidence of cognitive dysfunction after coronary artery bypass surgery.Conclusions:1. The incidence of cognitive dysfunction after coronary artery bypass surgery is still high; we should pay more attention to those patients.2. Patient’s age, operation time, the sensitivity of interpersonal relationship, neuroticism and exploitation of social support are the influence factors of postoperative cognitive dysfunction.