Investigation of the effect of anesthesia implementation with bispectral index on postoperative neurocognitive functions and delirium in open heart surgery

2021 ◽  
Vol 12 (3) ◽  
pp. 38-45
Author(s):  
Emir Izzet ◽  
Borulu Ferhat ◽  
Coskun Ceyhun ◽  
Muhammed Onur Hanedan ◽  
Mataracı Ilker
Keyword(s):  
Blood Pressure ◽  
Artery Bypass ◽  
Mental Test ◽  
Clock Drawing Test ◽  
Clock Drawing ◽  
Neurocognitive Functions ◽  
Arterial Blood ◽  
Drawing Test ◽  
Group 1

Background: Neurological complications of coronary artery bypass surgery are still the major causes of mortality and morbidity despite all advances in this field. Aims and Objectives: We investigated the effect of bispectral index (BIS) monitoring of the patient consciousness on the postoperative neurocognitive functions in our study. Materials and Methods: A total of 40 patients in the age range from 25 to 75 years were included in our study, who were electively operated for isolated coronary artery bypass grafting (CABG) surgery in the period from January 2014 to June 2014. The patients were assigned to two groups based on whether BIS monitoring was performed or not. The patients were consecutively allocated to either group when they were found eligible to be included based on the exclusion criteria. Administration of the anesthesia was monitored with BIS in the respective group (Group 1). All patient follow-up parameters were compared in both groups. Neurocognitive function tests (the clock drawing test and standardized mini mental test) were administered to the patients in the preoperative and postoperative period(1 st day and day before discharge). The results were compared. Results: There were no significant findings in the demographic features and the routine follow-up parameters between the two groups. The time of extubation, intensive care unit (ICU) follow-up parameters, and the length of stay in the ICU were not significantly different between the groups; however, the length of stay at the hospital was significantly longer in the group of patients, who were not monitored with BIS (p<0.05). The mean arterial blood pressure was statistically significantly higher in group 1 (BIS monitoring) at all phases of the operation and during the postoperative follow-ups. A significant acidosis was present in the arterial blood pressure tests of the patients in group 1 during their stay at the ICU. The Po2 values following cross-clamping and extubation were significantly higher in group 1. In the group monitored with BIS, the results of the neurocognitive tests, which were the clock drawing test and the standardized mini mental test, were both clinically and statistically superior (p<0.05). Conclusıons: BIS monitoring provides favorable contributions for the follow-up of the patients undergoing CABG surgery and it is helpful in estimating the consciousness state of the patients after the surgery.

Assessment of Cognitive Dysfunction in Hemodialysis Patients By the Mini Mental Test and the Clock Drawing Test

2018 ◽  
Author(s):  
Demet YILDIZ ◽  
Meral SEFEROĞLU ◽  
Aygül GÜNEŞ ◽  
Nilüfer BÜYÜKKOYUNCU ◽  
Abdülmecit YILDIZ ◽  
...  
Keyword(s):  
Cognitive Dysfunction ◽  
Hemodialysis Patients ◽  
Mental Test ◽  
Clock Drawing Test ◽  
Clock Drawing ◽  
Drawing Test

scholarly journals The Clock Drawing Test as a predictor of cognitive decline in non-demented stroke patients

2021 ◽  
Author(s):  
Ilaria Cova ◽  
Francesco Mele ◽  
Federica Zerini ◽  
Laura Maggiore ◽  
Silvia Rosa ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Cognitive Assessment ◽  
Stroke Patients ◽  
Term Care ◽  
Clock Drawing Test ◽  
Clock Drawing ◽  
Drawing Test ◽  
Incident Cases

Abstract Background The early detection of patients at risk of post-stroke cognitive impairment (PSCI) may help planning subacute and long-term care. We aimed to determine the predictivity of two screening cognitive tests on the occurrence of mild cognitive impairment or dementia in acute stroke patients. Methods A cognitive assessment within a few days of ischemic or hemorrhagic stroke was performed in patients consecutively admitted to a stroke unit over 14 months by means of the Clock Drawing Test (CDT) and the Montreal Cognitive Assessment-Basic (MoCA-B). Results Out of 191 stroke survivors who were non-demented at baseline, 168 attended at least one follow-up visit. At follow-up (mean duration ± SD 12.8 ± 8.7 months), 28 (18.9%) incident cases of MCI and 27 (18%) cases of dementia were recorded. In comparison with patients who remained cognitively stable at follow-up, these patients were older, less educated, had more comorbidities, a higher score on the National Institutes of Health Stroke Scale (NIHSS) at admission, more severe cerebral atrophy, and lower MoCA-B and CDT scores at baseline. In multi-adjusted (for age, education, comorbidities score, NIHSS at admission and atrophy score) model, a pathological score on baseline CDT (< 6.55) was associated with a higher risk of PSCI at follow-up (HR 2.022; 95% CI 1.025–3.989, p < 0.05) with respect to non-pathological scores. A pathological baseline score on MoCA-B (< 24) did not predict increased risk of cognitive decline at follow-up nor increased predictivity of stand-alone CDT. Conclusion A bedside cognitive screening with the CDT helps identifying patients at higher risk of PSCI.

scholarly journals Classifying Non-Dementia and Alzheimer’s Disease/Vascular Dementia Patients Using Kinematic, Time-Based, and Visuospatial Parameters: The Digital Clock Drawing Test

2021 ◽  
Vol 82 (1) ◽  
pp. 47-57 ◽  
Author(s):  
Anis Davoudi ◽  
Catherine Dion ◽  
Shawna Amini ◽  
Patrick J. Tighe ◽  
Catherine C. Price ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Vascular Dementia ◽  
Area Under The Curve ◽  
Clock Drawing Test ◽  
Digital Clock ◽  
Clock Drawing ◽  
Drawing Test ◽  
Dementia Patients ◽  
Optimal Area

Background: Advantages of digital clock drawing metrics for dementia subtype classification needs examination. Objective: To assess how well kinematic, time-based, and visuospatial features extracted from the digital Clock Drawing Test (dCDT) can classify a combined group of Alzheimer’s disease/Vascular Dementia patients versus healthy controls (HC), and classify dementia patients with Alzheimer’s disease (AD) versus vascular dementia (VaD). Methods: Healthy, community-dwelling control participants (n = 175), patients diagnosed clinically with Alzheimer’s disease (n = 29), and vascular dementia (n = 27) completed the dCDT to command and copy clock drawing conditions. Thirty-seven dCDT command and 37 copy dCDT features were extracted and used with Random Forest classification models. Results: When HC participants were compared to participants with dementia, optimal area under the curve was achieved using models that combined both command and copy dCDT features (AUC = 91.52%). Similarly, when AD versus VaD participants were compared, optimal area under the curve was, achieved with models that combined both command and copy features (AUC = 76.94%). Subsequent follow-up analyses of a corpus of 10 variables of interest determined using a Gini Index found that groups could be dissociated based on kinematic, time-based, and visuospatial features. Conclusion: The dCDT is able to operationally define graphomotor output that cannot be measured using traditional paper and pencil test administration in older health controls and participants with dementia. These data suggest that kinematic, time-based, and visuospatial behavior obtained using the dCDT may provide additional neurocognitive biomarkers that may be able to identify and tract dementia syndromes.

scholarly journals Digital Clock Drawing: Differentiating “Thinking” versus “Doing” in Younger and Older Adults with Depression

2014 ◽  
Vol 20 (9) ◽  
pp. 920-928 ◽  
Author(s):  
Jamie Cohen ◽  
Dana L. Penney ◽  
Randall Davis ◽  
David J. Libon ◽  
Rodney A. Swenson ◽  
...  
Keyword(s):  
Motor Performance ◽  
Psychomotor Speed ◽  
Psychomotor Slowing ◽  
Younger Adults ◽  
Clock Drawing Test ◽  
Digital Clock ◽  
Clock Drawing ◽  
Time To Completion ◽  
Drawing Test ◽  
Depressed Group

AbstractPsychomotor slowing has been documented in depression. The digital Clock Drawing Test (dCDT) provides: (i) a novel technique to assess both cognitive and motor aspects of psychomotor speed within the same task and (ii) the potential to uncover subtleties of behavior not previously detected with non-digitized modes of data collection. Using digitized pen technology in 106 participants grouped by Age (younger/older) and Affect (euthymic/unmedicated depressed), we recorded cognitive and motor output by capturing how the clock is drawn rather than focusing on the final product. We divided time to completion (TTC) for Command and Copy conditions of the dCDT into metrics of percent of drawing (%Ink) versus non-drawing (%Think) time. We also obtained composite Z-scores of cognition, including attention/information processing (AIP), to explore associations of %Ink and %Think times to cognitive and motor performance. Despite equivalent TTC, %Ink and %Think Command times (Copy n.s.) were significant (AgeXAffect interaction: p=.03)—younger depressed spent a smaller proportion of time drawing relative to thinking compared to the older depressed group. Command %Think time negatively correlated with AIP in the older depressed group (r=−.46; p=.02). Copy %Think time negatively correlated with AIP in the younger depressed (r=−.47; p=.03) and older euthymic groups (r=−.51; p=.01). The dCDT differentiated aspects of psychomotor slowing in depression regardless of age, while dCDT/cognitive associates for younger adults with depression mimicked patterns of older euthymics. (JINS, 2014, 20, 1–9)

The Four-Point Scoring System for the Clock Drawing Test Does Not Differentiate between Alzheimer's Disease and Vascular Dementia

2010 ◽  
Vol 106 (3) ◽  
pp. 941-948 ◽  
Author(s):  
April R. Wiechmann ◽  
James R. Hall ◽  
Sid O'bryant
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Vascular Dementia ◽  
Sensitivity And Specificity ◽  
Scoring System ◽  
Cutoff Score ◽  
Characteristic Analysis ◽  
Clock Drawing Test ◽  
Clock Drawing ◽  
Drawing Test

The purpose of this study was to explore the sensitivity and specificity of the Clock Drawing Test by using a widely employed four-point scoring system to discriminate between patients with Alzheimer's disease or vascular dementia. Receiver operating characteristic analysis indicated that the Clock Drawing Test was able to distinguish between normal elders and those with a dementia diagnosis. The cutoff score for differentiating patients with Alzheimer's disease from normal participants was = 3. The cutoff score for differentiating those with vascular disease from normal participants was = 3. Overall, the four-point scoring system demonstrated good sensitivity and specificity for identifying cognitive dysfunction associated with dementia; however, the current findings do not support the utility of the four-point scoring system in discriminating Alzheimer's disease and vascular dementia.

scholarly journals Learning classification models of cognitive conditions from subtle behaviors in the digital Clock Drawing Test

2015 ◽  
Vol 102 (3) ◽  
pp. 393-441 ◽  
Author(s):  
William Souillard-Mandar ◽  
Randall Davis ◽  
Cynthia Rudin ◽  
Rhoda Au ◽  
David J. Libon ◽  
...  
Keyword(s):  
Classification Models ◽  
Clock Drawing Test ◽  
Digital Clock ◽  
Clock Drawing ◽  
Drawing Test
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