| Saturday, July 16, 2005: 1:45 PM-3:15 PM | |||
| Neurocognitive Function, Delirium, and Patient Perceptions in the Perioperative Coronary Artery Bypass Graft Patient | |||
| Learning Objective #1: Identify the risk factors associated with postoperative cognitive deficits and delirium prior to hospital discharge after “off-pump” coronary artery bypass(OPCAB)graft surgery | |||
| Learning Objective #2: Recognize that there may be differences between objective neurocognitive function (measured by clinicians) and subjective neurocognitive symptoms and mental health status (perceived by the patient) | |||
| Physical outcomes after CABG show fairly consistent positive benefit to patients, despite increase in age and co-morbidities of patients undergoing CABG during the past decade. However, researchers and caregivers remain concerned about the significant sub-sample of patients who experience post-operative cognitive deterioration or delirium that may prolong hospitalization and increase costs. The relationship between neurocognitive function and patient-perceived quality of life is infrequently examined. The purpose of this symposium is 1) to enhance awareness of the significant correlates associated with the subgroup of patients undergoing CABG, subsequently demonstrating postoperative cognitive deterioration or delirium, and 2) to examine the association between objective and subjective neurocognitive function as well as patient-perceived mental health status. Current changes in characteristics of patients who undergo CABG, advances in surgical technique, and differences in post-operative nursing care make measurement of mental health after CABG challenging. Researchers should make a concerted effort to include various perioperative factors (e.g., preoperative anxiety, use or non-use of cardiopulmonary bypass pump) when measuring objective cognitive changes; a systematic and “round-the-clock” approach to screening for post-operative delirium; and higher priority for including evaluation of subjective health outcomes as they relate to objectively measured outcomes. The presentations report findings and implications from a study of neurocognitive and subjective outcomes of patients undergoing “on-pump” and “off-pump” CABG surgery at leading cardiovascular surgical centers in two large Midwestern tertiary care hospitals (April 2002 to January 2003). Participants were >21 years or older; had elective CABG without concurrent procedures, ability to communicate and give consent in English, no physical or neurocognitive impairment, and no preexisting or current psychiatric conditions. Standardized protocol was established to measure neuropsychological function and delirium during hospitalization, and subjective health status at 3 months after surgery. Demographic and clinical data were obtained through self-administered questionnaire and the Society of Thoracic Surgeons database. | |||
| Organizer: | Kristin E. Sandau, RN, PhD | ||
| Presenters: | Sue Sendelbach, RN, PhD, CCNS, FAHA Shigeaki Watanuki, RN, PhD | ||
| Neurocognitive Outcomes of Patients Following Off-Pump Coronary Artery Bypass Surgery Sue Sendelbach, RN, PhD, CCNS, FAHA, Shigeaki Watanuki, RN, PhD, Kristin E. Sandau, RN, PhD, Ruth Ann Lindquist, RN, PhD, APRN, BC, FAAN, Kay Savik, MS | |||
| Neurocognitive Screening at Hospital Discharge: How Do Objective Results Compare to Patient Perception Three Months after Coronary Artery Bypass Graft Surgery (CABG)? Kristin E. Sandau, RN, PhD, Sue Sendelbach, RN, PhD, CCNS, FAHA, Shigeaki Watanuki, RN, PhD, Ruth Ann Lindquist, RN, PhD, APRN, BC, FAAN, Kay Savik, MS | |||
| The course and correlates of delirium among patients undergoing off-pump coronary artery bypass graft surgery Shigeaki Watanuki, RN, PhD, Ruth Ann Lindquist, RN, PhD, APRN, BC, FAAN, Sue Sendelbach, RN, PhD, CCNS, FAHA, Kristin E. Sandau, RN, PhD | |||