Descripción de Cambios Neurocognitivos en Pacientes Con Enfermedad Coronaria Llevados A Cirugía Cardiaca Con Circulación Extracorpórea Vs Manejo Médico En El Hospital Militar Central Durante El Seguimiento a 6 Meses
Estudio descriptivo de 23 pacientes adultos con enfermedad coronaria atendidos en el servicio de cirugía cardiovascular del Hospital Militar Central en el periodo comprendido entre marzo de 2019 a marzo de 2020 en el cual se realizó un análisis exploratorio de variables sociodemográficas y de prueba...
- Autores:
-
Alvarez Gonzalez, Maria Carolina
Bernal Pacheco, Oscar
Tovar Sanchez, Robert
- Tipo de recurso:
- Trabajo de grado de pregrado
- Fecha de publicación:
- 2020
- Institución:
- Universidad Militar Nueva Granada
- Repositorio:
- Repositorio UMNG
- Idioma:
- spa
- OAI Identifier:
- oai:repository.unimilitar.edu.co:10654/37388
- Acceso en línea:
- http://hdl.handle.net/10654/37388
- Palabra clave:
- Coronary artery bypass graft
Cardiac surgery
Postoperative cognitive deficit
Postoperative cognitive impairment
Cognitive domain
Psychometric test
Cognitive reserve
NEUROLOGIA
Enfermedad coronaria - Cirugía
Trastornos neurocognitivos
Cuidados postoperatorios
Injerto de derivación de arteria coronaria
Cirugía cardíaca
Déficit cognitivo posoperatorio
Deterioro cognitivo posoperatorio
Dominio cognitivo
Pruebas psicométricas
Reserva cognitiva
- Rights
- openAccess
- License
- http://creativecommons.org/licenses/by-nc-nd/4.0/
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Descripción de Cambios Neurocognitivos en Pacientes Con Enfermedad Coronaria Llevados A Cirugía Cardiaca Con Circulación Extracorpórea Vs Manejo Médico En El Hospital Militar Central Durante El Seguimiento a 6 Meses |
| dc.title.translated.spa.fl_str_mv |
Description Of Neurocognitive Changes In Patients With Coronary Disease Taken To Cardiac Surgery With Extracorporeal Circulation Vs Medical Management In The Central Military Hospital During The 6-Month Follow-Up |
| title |
Descripción de Cambios Neurocognitivos en Pacientes Con Enfermedad Coronaria Llevados A Cirugía Cardiaca Con Circulación Extracorpórea Vs Manejo Médico En El Hospital Militar Central Durante El Seguimiento a 6 Meses |
| spellingShingle |
Descripción de Cambios Neurocognitivos en Pacientes Con Enfermedad Coronaria Llevados A Cirugía Cardiaca Con Circulación Extracorpórea Vs Manejo Médico En El Hospital Militar Central Durante El Seguimiento a 6 Meses Coronary artery bypass graft Cardiac surgery Postoperative cognitive deficit Postoperative cognitive impairment Cognitive domain Psychometric test Cognitive reserve NEUROLOGIA Enfermedad coronaria - Cirugía Trastornos neurocognitivos Cuidados postoperatorios Injerto de derivación de arteria coronaria Cirugía cardíaca Déficit cognitivo posoperatorio Deterioro cognitivo posoperatorio Dominio cognitivo Pruebas psicométricas Reserva cognitiva |
| title_short |
Descripción de Cambios Neurocognitivos en Pacientes Con Enfermedad Coronaria Llevados A Cirugía Cardiaca Con Circulación Extracorpórea Vs Manejo Médico En El Hospital Militar Central Durante El Seguimiento a 6 Meses |
| title_full |
Descripción de Cambios Neurocognitivos en Pacientes Con Enfermedad Coronaria Llevados A Cirugía Cardiaca Con Circulación Extracorpórea Vs Manejo Médico En El Hospital Militar Central Durante El Seguimiento a 6 Meses |
| title_fullStr |
Descripción de Cambios Neurocognitivos en Pacientes Con Enfermedad Coronaria Llevados A Cirugía Cardiaca Con Circulación Extracorpórea Vs Manejo Médico En El Hospital Militar Central Durante El Seguimiento a 6 Meses |
| title_full_unstemmed |
Descripción de Cambios Neurocognitivos en Pacientes Con Enfermedad Coronaria Llevados A Cirugía Cardiaca Con Circulación Extracorpórea Vs Manejo Médico En El Hospital Militar Central Durante El Seguimiento a 6 Meses |
| title_sort |
Descripción de Cambios Neurocognitivos en Pacientes Con Enfermedad Coronaria Llevados A Cirugía Cardiaca Con Circulación Extracorpórea Vs Manejo Médico En El Hospital Militar Central Durante El Seguimiento a 6 Meses |
| dc.creator.fl_str_mv |
Alvarez Gonzalez, Maria Carolina Bernal Pacheco, Oscar Tovar Sanchez, Robert |
| dc.contributor.advisor.none.fl_str_mv |
Centanaro Meza, Gabriel |
| dc.contributor.author.none.fl_str_mv |
Alvarez Gonzalez, Maria Carolina Bernal Pacheco, Oscar Tovar Sanchez, Robert |
| dc.contributor.corporatename.spa.fl_str_mv |
Hospital Militar Central |
| dc.subject.keywords.spa.fl_str_mv |
Coronary artery bypass graft Cardiac surgery Postoperative cognitive deficit Postoperative cognitive impairment Cognitive domain Psychometric test Cognitive reserve |
| topic |
Coronary artery bypass graft Cardiac surgery Postoperative cognitive deficit Postoperative cognitive impairment Cognitive domain Psychometric test Cognitive reserve NEUROLOGIA Enfermedad coronaria - Cirugía Trastornos neurocognitivos Cuidados postoperatorios Injerto de derivación de arteria coronaria Cirugía cardíaca Déficit cognitivo posoperatorio Deterioro cognitivo posoperatorio Dominio cognitivo Pruebas psicométricas Reserva cognitiva |
| dc.subject.decs.spa.fl_str_mv |
NEUROLOGIA Enfermedad coronaria - Cirugía Trastornos neurocognitivos Cuidados postoperatorios |
| dc.subject.proposal.spa.fl_str_mv |
Injerto de derivación de arteria coronaria Cirugía cardíaca Déficit cognitivo posoperatorio Deterioro cognitivo posoperatorio Dominio cognitivo Pruebas psicométricas Reserva cognitiva |
| description |
Estudio descriptivo de 23 pacientes adultos con enfermedad coronaria atendidos en el servicio de cirugía cardiovascular del Hospital Militar Central en el periodo comprendido entre marzo de 2019 a marzo de 2020 en el cual se realizó un análisis exploratorio de variables sociodemográficas y de pruebas neuropsicológicas comparando el resultado del puntaje escalar en los pacientes antes de ser llevados a cirugía y 6 meses después de la misma y así mismo de pacientes no llevados a cirugía. Las comorbilidades más frecuentes encontradas fueron infarto de miocardio, falla cardiaca y diabetes, la revascularización fue el procedimiento realizado con más frecuencia y el delirio postoperatorio se observó en un cuarto de los pacientes. La tendencia a la estabilidad en las puntuaciones basales y a 6 meses se observó en los dos grupos de tratamiento en los dominios cognitivos evaluados excepto por la atención que tuvo una reducción estadísticamente significativa en el grupo quirúrgico a 6 meses. Se identificaron factores de riesgo descritos para déficit neurocognitivo como lo edad mayor de 70 años, enfermedad coronaria y diabetes mellitus, anemia intraoperatoria y delirium postoperatorio. Se encontró cambio a nivel de la atención alternante, flexibilidad cognitiva y velocidad de procesamiento en el grupo quirúrgico a 6 meses con respecto al grupo de tratamiento médico. Se propone la evaluación neuropsicológica como parte de la valoración pre quirúrgica de los pacientes llevados a cirugía cardiaca con circulación extracorpórea para adoptar medidas preventivas preoperatorias y durante el procedimiento quirúrgico, además de optimizar el manejo del delirium postoperatorio. |
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2020 |
| dc.date.issued.none.fl_str_mv |
2020-11-12 |
| dc.date.accessioned.none.fl_str_mv |
2021-01-18T17:11:47Z |
| dc.date.available.none.fl_str_mv |
2021-01-18T17:11:47Z |
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Tesis/Trabajo de grado - Monografía - Especialización |
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info:eu-repo/semantics/bachelorThesis |
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http://purl.org/coar/resource_type/c_7a1f |
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http://hdl.handle.net/10654/37388 |
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instname:Universidad Militar Nueva Granada |
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reponame:Repositorio Institucional Universidad Militar Nueva Granada |
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repourl:https://repository.unimilitar.edu.co |
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| dc.relation.references.spa.fl_str_mv |
McDonagh DL, Berger M, Mathew JP, Graffagnino C, Milano CA, Newman MF. Neurological complications of cardiac surgery. The Lancet Neurology. 2014. 2. Tully PJ, Baker RA. Current readings: Neurocognitive impairment and clinical implications after cardiac surgery. Semin Thorac Cardiovasc Surg. 2013; 3. Pérez-Belmonte LM, San Román-Terán CM, Jiménez-Navarro M, Barbancho MA, García-Alberca JM, Lara JP. Assessment of long-term cognitive impairment after off-pump coronary-artery bypass grafting and related risk factors. J Am Med Dir Assoc. 2015; 4. Anastasiadis K, Argiriadou H, Kosmidis MH, Megari K, Antonitsis P, Thomaidou E, et al. Neurocognitive outcome after coronary artery bypass surgery using minimal versus conventional extracorporeal circulation: A randomised controlled pilot study. Heart. 2011; 5. Bhamidipati D, Goldhammer JE, Sperling MR, Torjman MC, McCarey MM, Whellan DJ. Cognitive Outcomes After Coronary Artery Bypass Grafting. J Cardiothorac Vasc Anesth [Internet]. 2017;31(2):707–18. Available from: http://linkinghub.elsevier.com/retrieve/pii/S1053077016304360 6. Ghaeli P, Ghaffary S, Hajhossein Talasaz A, Karimi A, Salehiomran A, Hajighasemi A, et al. Association between Perioperative Parameters and Cognitive Impairment in Post-Cardiac Surgery Patients [Internet]. Vol. 10, J Teh Univ Heart Ctr. 2015. Available from: http://jthc.tums.ac.ir 7. Rasmussen LS, Stygall J, Newman SP. Disfunción cognitiva y otras complicaciones a largo plazo de cirugía y anestesia. 2016. 8. Carrascal Y, Guerrero AL. Neurological damage related to cardiac surgery: Pathophysiology, diagnostic tools and prevention strategies. Using actual knowledge for planning the future. Neurologist. 2010. 9. Murkin JM, Newman SP, Stump DA, Blumenthal JA. Statement of consensus on assessment of neurobehavioral outcomes after cardiac surgery. Ann Thorac Surg. 1995;59(5):1289–95. 10. Saczynski JS, Marcantonio ER, Quach L, et al. Cognitive trajectories after postoperative delirium. N Engl J Med 2012; 367: 30–39. 11. Arenson BG, MacDonald LA, Grocott HP, Hiebert BM, Arora RC. Eff ect of intensive care unit environment on in-hospital delirium after cardiac surgery. J Thorac Cardiovasc Surg 2013; 146: 172–78. 12. Feinkohl I, Winterer G, Spies CD, Pischon T. Cognitive reserve and the risk of postoperative cognitive dysfunction - A systematic review and meta-analysis. Deutsches Arzteblatt International. 2017. 13. Ropacki SA, Bert AA, Ropacki MT, Rogers BL, Stern RA. The influence of cognitive reserve on neuropsychological functioning following coronary artery bypass grafting (CABG). Arch Clin Neuropsychol. 2007;22(1):73–85. 14. Parra VM, Sadurní M, Doñate M, Rovira I, Roux C, Ríos J, et al. Disfunción cognitiva después de cirugía cardiaca. Saturación cerebral e índice biespectral: estudio longitudinal Neuropsychological dysfunction after cardiac surgery. Cerebral saturation and bispectral index: A longitudinal study. Vol. 139, Rev Med Chile. 2011. 15. Hall, R. A., Fordyce, D. J., Lee, M. E., Eisenberg, B., Lee, R. F., Holmes, J. H., 4th, et al. (1999). Brain SPECT imaging and neuropsychological testing in coronary artery bypass patients: Single photon emission computed tomography. Annals of Thoracic Surgery, 68, 2082–2088. 16.M. Cibelli, A. R. Fidalgo, N. Terrando et al., “Role of interleukin- 1��������������������� in postoperative cognitive dysfunction,” Annals of Neurology, vol. 68, no. 3, pp. 360–368, 2010. 17 D. Wang, X. Wu, J. Li, F. Xiao, X. Liu, and M. Meng, “ e e ect of lidocaine on early postoperative cognitive dysfunction a er coronary artery bypass surgery,” Anesthesia and Analgesia, vol. 95, no. 5, pp. 1134–1141, 2002. 18 L. G. Svensson, E. M. Nadolny, D. L. Penney et al., “Prospective randomized neurocognitive and S-100 study of hypothermic circulatory arrest, retrograde brain perfusion, and antegrade brain perfusion for aortic arch operations,” Annals of oracic Surgery, vol. 71, no. 6, pp. 1905–1912, 2001. 19. Woodbridge PD. Changing concepts concerning depth of anaesthesia. Anaesthesiology1957;18:536. 20. Detection of awareness in surgical patients with EEG-based indicesÐbispectral index and patient state index. Department of Anaesthesiology, Klinikum rechts der Isar, Technische UniversitaÈt MuÈnchen, Ismaningerstr. 22, D-81675 Munich, Germany British Journal of Anaesthesia 91 (3): 329±35 (2003) 21. Clinical Electroencephalography for Anesthesiologists Part I: Background and Basic Signatures. Patrick L. Purdon, Ph.D.*, Aaron Sampson, B.S.§, Kara J. Pavone, B.S.§, and Emery N. Brown, M.D., Ph.D. Published in final edited form as: Anesthesiology. 2015 October ; 123(4): 937–960. 22. Cognitive dysfunction after cardiac surgery: Pathophysiological mechanisms and preventive strategies, E. F. Bruggemans, Department of Cardiothoracic Surgery, Leiden University Medical 23. Postoperative cognitive dysfunction after cardiac surgery Audrey Miang Ying Tan MBBS FRCA Derek Amoako MBChB FRCA Continuing Education in Anaesthesia, Critical Care & Pain j Volume 13 Number 6 2013 219 24. Predictors of postoperative cognitive dysfunction in adult patients undergoing elective cardiac surgery Indian Journal of Anaesthesia | Vol. 58 | Issue 3 | May-Jun 2014 25. Phillips-Bute B, Mathew JP, Blumenthal JA, Grocott HP, Laskowitz DT, Jones RH, et al. Association of neurocognitive function and quality of life 1 year after Coronary Artery Bypass Graft (CABG) surgery. Psychosom Med. 2006;68(3):369–75. 26. Quach L, Saczynski JS, Jones RN, Marcantonio ER, Inouye SK, Gross A, et al. Cognitive Trajectories After Postoperative Delirium. Surv Anesthesiol. 2012;56(6):286–7. 27. Banayan D, Groen JA, Bhalerao S, Gupta S, Xu S. Treatment of Delirium Following Cardiac Surgery. J Card Surg. 2012;27(5):589–93. 28. Gosselt ANC, Slooter AJC, Boere PRQ, Zaal IJ. Risk factors for delirium after on-pump cardiac surgery: A systematic review. Crit Care [Internet]. 2015;19(1):1–8. Available from: http://dx.doi.org/10.1186/s13054-015-1060-0 29. Copia de neuropsicologia en colombia ARANGO (2).pdf. 30. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373-83. 22.22. Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol. 2011 Mar 15; 173(6): 676-82. 31. Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol. 2011 Mar 15; 173(6): 676-82. 32. Manual Diagnostico y Estadistico de los Trastornos Mentales DSM V, 5 edicion, editorial Panamericana,2014.pdf. 33. Postoperative cognitive disorders Terri G. Monka and Catherine C. Priceb aDepartment of Anesthesiology, Duke University, Medical Center, Durham Veterans Administration, Medical Center, Durham, North Carolina, USA bClinical and Health Psychology & Department of Anesthesiology, University of Florida, Gainesville, Florida, USA 34. The Confusion Assessment Method (CAM): A Systematic Review of Current Usage. Leslie A. Wei, B.A.1, Michael A. Fearing, Ph.D.2,3, Eliezer J. Sternberg4, and Sharon K. Inouye, M.D., MPH2,3 1 Brown Medical School, Providence RI 2 Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife, Boston, MA 3 Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 4 Brandeis University, Waltham, MA. J Am Geriatr Soc. 2008 May ; 56(5): 823–830. doi:10.1111/j.1532-5415.2008.01674.x. 35. Glumac S, Kardum G, Karanovic N. Postoperative cognitive decline after cardiac surgery: A narrative review of current knowledge in 2019. Med Sci Monit. 2019;25:3262–70. 36. Browndyke JN, Ph D, Newman MF, Mathew JP, Sc MH. From Phenotypes to Mechanisms. 2018;(Xxx):1–23. 37. Benson, R., Ozdemir, B., Matthews, D., & Loftus, I. (2017). A systematic review of postoperative cognitive decline following open and endovascular aortic aneurysm surgery. The Annals of The Royal College of Surgeons of England, 99(2), 97–100. doi:10.1308/rcsann.2016.0338 38. Urits I, Orhurhu V, Jones M, Hoyt D, Seats A, Viswanath O. Current perspectives on postoperative cognitive dysfunction in the ageing population. Turkish J Anaesthesiol Reanim. 2019;47(6):439–47. 39. Evered, L., Silbert, B., Knopman, D. S., Scott, D. A., DeKosky, S. T., Rasmussen, L. S., … Xie, Z. (2018). TEMPORARY REMOVAL: Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery—2018. British Journal of Anaesthesia. doi:10.1016/j.bja.2017.11.087 40. Gerriets, T., Schwarz, N., Bachmann, G., Kaps, M., Kloevekorn, W.-P., Sammer, G., … Schönburg, M. (2010). Evaluation of Methods to Predict Early Long-Term Neurobehavioral Outcome After Coronary Artery Bypass Grafting. The American Journal of Cardiology, 105(8), 1095–1101. doi:10.1016/j.amjcard.2009.12.009 41. Grichnik KP, Ijsselmuiden AJJ, D’Amico TA, Harpole DH, White WD, Blumenthal JA, et al. Cognitive decline after major noncardiac operations: A preliminary prospective study. Ann Thorac Surg. 1999;68(5):1786–91. 42. Burrage, P. S., Low, Y. H., Campbell, N. G., & O’Brien, B. (2019). New-Onset Atrial Fibrillation in Adult Patients After Cardiac Surgery. Current Anesthesiology Reports, 9(2), 174–193. doi:10.1007/s40140-019-00321-4 43. McKhann, G. M., Grega, M. A., Borowicz, L. M., Bailey, M. M., Barry, S. J. E., Zeger, S. L., … Selnes, O. A. (2005). Is there cognitive decline 1 year after CABG?: Comparison with surgical and nonsurgical controls. Neurology, 65(7), 991–999. doi:10.1212/01.wnl.0000175220.78475.99 44.Keizer AM,HijmanR,Kalkman CJ,et al. The incidence ofc ognitive decline after(not)undergoing coronary artery bypass grafting: The impact of acontrol led definition. ActaAnaesthesiolScand2005;49:1232–5. 45. Knipp, S. C., Matatko, N., Wilhelm, H., Schlamann, M., Massoudy, P., Forsting, M., … Jakob, H. (2004). Evaluation of brain injury after coronary artery bypass grafting. A prospective study using neuropsychological assessment and diffusion-weighted magnetic resonance imaging☆. European Journal of Cardio-Thoracic Surgery, 25(5), 791–800. doi:10.1016/j.ejcts.2004.02.012 46. Moller, J., Cluitmans, P., Rasmussen, L., Houx, P., Rasmussen, H., Canet, J., … Gravenstein, J. (1998). Long-term postoperative cognitive dysfunction in the elderly: ISPOCD1 study. The Lancet, 351(9106), 857–861. doi:10.1016/s0140-6736(97)07382-0 47. Shiraboina, M., Ayya, S., Kumar, R., Durga, P., Gopinath, R., & Srikanth, Y. (2014). Predictors of postoperative cognitive dysfunction in adult patients undergoing elective cardiac surgery. Indian Journal of Anaesthesia, 58(3), 334. doi:10.4103/0019-5049.135077 |
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Centanaro Meza, GabrielAlvarez Gonzalez, Maria CarolinaBernal Pacheco, OscarTovar Sanchez, RobertEspecialista en NeurologíaHospital Militar CentralBogota Colombiamarzo 2019 a marzo de 2020Medicina2021-01-18T17:11:47Z2021-01-18T17:11:47Z2020-11-12http://hdl.handle.net/10654/37388instname:Universidad Militar Nueva Granadareponame:Repositorio Institucional Universidad Militar Nueva Granadarepourl:https://repository.unimilitar.edu.coEstudio descriptivo de 23 pacientes adultos con enfermedad coronaria atendidos en el servicio de cirugía cardiovascular del Hospital Militar Central en el periodo comprendido entre marzo de 2019 a marzo de 2020 en el cual se realizó un análisis exploratorio de variables sociodemográficas y de pruebas neuropsicológicas comparando el resultado del puntaje escalar en los pacientes antes de ser llevados a cirugía y 6 meses después de la misma y así mismo de pacientes no llevados a cirugía. Las comorbilidades más frecuentes encontradas fueron infarto de miocardio, falla cardiaca y diabetes, la revascularización fue el procedimiento realizado con más frecuencia y el delirio postoperatorio se observó en un cuarto de los pacientes. La tendencia a la estabilidad en las puntuaciones basales y a 6 meses se observó en los dos grupos de tratamiento en los dominios cognitivos evaluados excepto por la atención que tuvo una reducción estadísticamente significativa en el grupo quirúrgico a 6 meses. Se identificaron factores de riesgo descritos para déficit neurocognitivo como lo edad mayor de 70 años, enfermedad coronaria y diabetes mellitus, anemia intraoperatoria y delirium postoperatorio. Se encontró cambio a nivel de la atención alternante, flexibilidad cognitiva y velocidad de procesamiento en el grupo quirúrgico a 6 meses con respecto al grupo de tratamiento médico. Se propone la evaluación neuropsicológica como parte de la valoración pre quirúrgica de los pacientes llevados a cirugía cardiaca con circulación extracorpórea para adoptar medidas preventivas preoperatorias y durante el procedimiento quirúrgico, además de optimizar el manejo del delirium postoperatorio.1. RESUMEN DEL PROYECTO ................................................................................... VII 2. IDENTIFICACIÓN Y FORMULACIÓN DEL PROBLEMA ................................. 9 2.1 DEFINICIÓN DE DEFICIT COGNITIVO POSTOPERATORIO ................................. 9 2.2 EPIDEMIOLOGÍA DEL TRASTORNO: ...................................................................... 10 2.3 FISIOPATOLOGIA ....................................................................................................... 10 2.4 FACTORES DE RIESGO .............................................................................................. 12 2.5 FACTORES PROTECTORES ....................................................................................... 14 2.6 DIAGNOSTICO ............................................................................................................. 14 2.7 MANEJO ........................................................................................................................ 15 2.8 ESTADO DEL ARTE .................................................................................................... 15 3. PREGUNTA DE INVESTIGACIÓN .................................................................... 17 4. OBJETIVOS ................................................................................................................ 18 4.1 OBJETIVO GENERAL: .......................................................................................... 18 4.2 OBJETIVOS ESPECÍFICOS: ................................................................................. 18 5. METODOLOGÍA ....................................................................................................... 19 5.1 Clasificación del diseño del estudio. ............................................................................ 19 5.2 Lugar donde se realizó la investigación. ..................................................................... 19 5.3 Características de la población estudiada. ................................................................. 19 5.4 Variables que se midieron en el estudio. .................................................................... 19 5.5 Aspectos del proceso de medición y seguimiento. ...................................................... 34 5.6 Muestra .......................................................................................................................... 34 5.7 Criterios de Selección ................................................................................................... 34 5.7.1 Criterios de Inclusión ................................................................................................ 34 5.7.2 Criterios de Exclusión ............................................................................................... 35 5.8 Mediciones e instrumentos utilizados ......................................................................... 35 6. PLAN DE ANÁLISIS ................................................................................................. 38 7. ASPECTOS ETICOS .................................................................................................. 39 8. RESULTADOS ............................................................................................................ 41 9. DISCUSION ................................................................................................................. 46 IV 10. CONCLUSIONES ................................................................................................... 49 11. BIBLIOGRAFÍA ..................................................................................................... 50Descriptive study of 23 adult patients with coronary disease treated in the cardiovascular surgery service of the Central Military Hospital in the period from March 2019 to March 2020 in which an exploratory analysis of sociodemographic variables and neuropsychological tests was carried out comparing the result of the scalar score in patients before being taken to surgery and 6 months after it and likewise in patients not taken to surgery. The most frequent comorbidities found were myocardial infarction, heart failure, and diabetes, revascularization was the most frequently performed procedure, and postoperative delirium was observed in a quarter of the patients. The trend towards stability in the baseline scores and at 6 months was observed in the two treatment groups in the cognitive domains evaluated, except for the attention that had a statistically significant reduction in the surgical group at 6 months. Risk factors described for neurocognitive deficit were identified, such as age over 70 years, coronary disease and diabetes mellitus, intraoperative anemia and postoperative delirium. Change was found in the level of alternating attention, cognitive flexibility and processing speed in the surgical group at 6 months compared to the medical treatment group. Neuropsychological evaluation is proposed as part of the pre-surgical assessment of patients undergoing cardiac surgery with extracorporeal circulation to adopt preoperative preventive measures and during the surgical procedure, in addition to optimizing the management of postoperative delirium.Especializaciónapplicaction/pdfspahttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial-NoDerivatives 4.0 InternationalAcceso abiertoDescripción de Cambios Neurocognitivos en Pacientes Con Enfermedad Coronaria Llevados A Cirugía Cardiaca Con Circulación Extracorpórea Vs Manejo Médico En El Hospital Militar Central Durante El Seguimiento a 6 MesesDescription Of Neurocognitive Changes In Patients With Coronary Disease Taken To Cardiac Surgery With Extracorporeal Circulation Vs Medical Management In The Central Military Hospital During The 6-Month Follow-UpTesis/Trabajo de grado - Monografía - Especializacióninfo:eu-repo/semantics/bachelorThesishttp://purl.org/coar/resource_type/c_7a1fCoronary artery bypass graftCardiac surgeryPostoperative cognitive deficitPostoperative cognitive impairmentCognitive domainPsychometric testCognitive reserveNEUROLOGIAEnfermedad coronaria - CirugíaTrastornos neurocognitivosCuidados postoperatoriosInjerto de derivación de arteria coronariaCirugía cardíacaDéficit cognitivo posoperatorioDeterioro cognitivo posoperatorioDominio cognitivoPruebas psicométricasReserva cognitivaNeurologíaFacultad de MedicinaUniversidad Militar Nueva GranadaMcDonagh DL, Berger M, Mathew JP, Graffagnino C, Milano CA, Newman MF. 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