Background: 

Neurocognitive decline (NCD) is a common complication of cardiac surgery. Understanding risk factors helps surgeons counsel patients pre- and peri-operatively about risk, prevention, and treatment.

Results: 

Eighty-four patients undergoing cardiac surgery utilizing cardiopulmonary bypass underwent pre- and post-operative neurocognitive testing. Neurocognitive data are presented as a change from baseline to either postoperative day four (POD4) or to one month. The score is standardized with respect to age. There was no significant difference in baseline neurocognitive function. NCD was more common in female patients (71%) than male patients (26.4%) on POD4. By one month the incidence of NCD is similar between female (15.0%) and male patients (14.3%). Of note, female patients differed from male patients in preoperative hematocrit, preoperative creatinine, and type of surgery.

Conclusion: 

In the acute postoperative period, female patients are both more likely to experience NCD and experience a more severe change from baseline cognitive function. This difference between male and female patients resolves by the one month follow-up point. Female patients had a lower preoperative hematocrit and were more likely to receive intraoperative and perioperative blood transfusions. Lower pre-operative hematocrit appears to mediate the difference in NCD between male and female patients.