Features of structure and predictors of cognitive disorders in patients after cardiac surgery
Bibliographic record
Abstract
Abstract Background Cognitive disorders (CDs) are the most common neurological complications in cardiac surgery. Understanding the predictors associated with the occurrence of CDs, identifying modified risk factors, can accelerate recovery, improve prevention and treatment algorithms after cardiac surgery. The aim - to determine the structure and predictors of CDs in patients before surgery and in the early postoperative period (3rd and 7th days). Methods 56 patients were examined, including 19 (33.9%) men (p=0.02). The average age of the patients was 60.86±8.87 years. Cardiac surgery was performed for coronary heart disease in 37 (66.1%) and valvular heart disease in 19 (33.9%) patients (p=0.02). The duration of the operation ranged from 240 to 600 minutes, averaging 371.94±102.04 minutes. In 25 (44.6%) cases, the operations were performed in conditions of cardiopulmonary bypass (CB), the average duration of which didn't differ from operations without CB (389.44±116.88 vs. 355.47±86.16, p=0.34). Testing was performed before surgery, on the 3rd and 7th day of the postoperative period using Montreal Cognitive Test. Statistical processing was performed using the statistical software package SPSS 12.0 for Windows. Results 75% of the patients already had mild CDs before surgery. The structure of CDs in the early postoperative period didn't differ from the data before surgery, however, there were patients with severe CDs (3.6% and 2% vs. 0%, p=0.05). In the structure of the CDs on the 3rd day of the postoperative period there were a significant decrease of visuospatial skills (4.07 vs. 3.7, p<0.001), ability to consistent calculation (2.66 vs. 2.45, p=0.02), repetition of the phrase (1.16 vs. 1.0, p=0.02). On the 7th day of the postoperative period, there were a significant decrease of verbal speed (0.48 vs. 0.32, p=0.006) and memory improvement (1.79 vs. 2.29, p=0.01). The probable predictors of CDs in the early postoperative period are: history of stroke – r=−0.282, p=0.04; presence of atherosclerotic plaques in the coronary arteries according to coronary angiography – r=−0.259, p=0.05; surgery with CB – r=0.29, p=0.03 and presence signs of dyslipidemia according to the lipid profile – r=−0.227, p=0.09. Conclusions 75% of the patients already had mild CD before surgery. The structure of CDs in the early postoperative period didn't differ from the data before surgery, however, there were patients with severe CD. In the structure of the CDs on the 3rd day of the postoperative period there were a significant decrease of visuospatial, ability to consistent calculation, repetition of the phrase. On the 7th day of the postoperative period, there were a significant decrease in verbal speed and memory improvement. Probable predictors of CDs in the early postoperative period are: history of stroke; presence of atherosclerotic plaques in the coronary arteries; surgery with CB and presence of signs of dyslipidemia. Funding Acknowledgement Type of funding sources: None.
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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) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| 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) | 0.002 | 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".