Early postoperative cognitive dysfunction after simultaneous coronary artery bypass grafting and carotid endarterectomy
Bibliographic record
Abstract
Abstract Purpose To assess cognitive status after simultaneous coronary artery bypass grafting (CABG) and carotid endarterectomy (CEE). Material & methods. Changes in cognitive status and the incidence of POCD were evaluated in the early postoperative period after simultaneous CABG and CEE. 53 patients with polyvascular disease (PolyVD) undergoing CABG and CEE were included in the study. Patients were assigned to two groups. 25 patients without mild cognitive impairment (MCI), the mean age of 64.3±7.9 years, were included in Group 1 and 28 patients with MCI, the mean age of 65.3±6.75 years, were included in Group 2. Neuropsychological testing was performed on days 2 before surgery and on days 7 after surgery using the psycho-physiological testing software “Status PF”. Attention was assessed with the Bourdon's test or proofreading test. Memory was estimated with the 10 numbers memorizing test, 10 words memorizing test, and 10 syllables memorizing test. The assessment of neurodynamics included the measurement of the complex visual-motor reaction time (VMRT), brain performance (BP), and functional mobility of the nervous processes (FMNP). The presence of POCD was estimated as a 20% decline on 20% of the tests. A reference range for neuropsychological indicators (13 indicators of the test battery) was set at the intervals corresponding to the ranges between the quartiles [Q25; Q75] in healthy people. Thus, cognitive status scale includes low cognitive status with the values ranging from 0 to 0.34, below the average - from 0.35 to 0.51, the average - from 0.52 to 0.7, and high cognitive status >0.7 to 1.0. Early postoperative cognitive dysfunction (POCD) was diagnosed as a 20% decline in memory, attention, and neurodynamics from the baseline on 20% of the tests passed. Statistical analysis was performed using the “Advanced” software package. Results At baseline, cognitive status in patients without MCI was below the average (0.38±0.2), whereas in MCI patients it was lower by 32% and corresponded to low (0.26±0.1; p=0.03). Cognitive status did not differ significantly between both groups in the postoperative period, but a trend towards its decrease was determined (0.34±0.2 vs. 0.27±0.13, p>0.5). However, the incidence of early POCD in patients without MCI was 14 (56%), and in patients with MCI - 20 (71%) patients. Conclusion At baseline, patients with PolyVD, regardless of the presence of MCI, according to the results of the comprehensive examination, showed low and below the average cognitive status. Simultaneous CABG and CEE does not prevent the deterioration of cognitive functions in patients with PolyVD in the early postoperative period. Patients with PolyVD undergoing myocardial and brain revascularization have a high risk of worsening cognitive disorders and need to individual approach to make a reasonable choice of the optimal surgical strategy. Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): Institute
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".