Exploring cognitive function and postoperative neurocognitive recovery after cardiac surgery in older adults (ECPON): a protocol for an observational study

Introduction Cardiovascular disease is one of the most common health issues facing the older population, and the number of older adults undergoing cardiac surgery is expected to increase. Postoperative neurocognitive impairment is a frequent and often unrecognised complication that can adversely aff...

Full description

Saved in:
Bibliographic Details
Main Authors: Ulrica Nilsson, Markus Saarijärvi, Lina Bergman, Jeanette Eckerblad, Gabriela Markovic, Ernad Zecevic, Tor Damén, Anna Martinik
Format: Article
Language:English
Published: BMJ Publishing Group 2025-06-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/6/e098208.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849683070925406208
author Ulrica Nilsson
Markus Saarijärvi
Lina Bergman
Jeanette Eckerblad
Gabriela Markovic
Ernad Zecevic
Tor Damén
Anna Martinik
author_facet Ulrica Nilsson
Markus Saarijärvi
Lina Bergman
Jeanette Eckerblad
Gabriela Markovic
Ernad Zecevic
Tor Damén
Anna Martinik
author_sort Ulrica Nilsson
collection DOAJ
description Introduction Cardiovascular disease is one of the most common health issues facing the older population, and the number of older adults undergoing cardiac surgery is expected to increase. Postoperative neurocognitive impairment is a frequent and often unrecognised complication that can adversely affect a patient’s recovery, quality of life and daily activities, as well as impact the lives of their family members. Patients may express cognitive difficulties as a feeling of ‘not being the same since the operation’. This study aims to investigate the factors that influence neurocognitive function and patient-reported cognitive symptoms among patients aged 65 and older following cardiac surgery, and explore the impact on the overall postoperative recovery. Additionally, the study aims to describe the perspectives of close relatives on the recovery process.Methods and analysis A longitudinal observational study with a mixed-methods approach will be conducted in two thoracic surgical departments in Sweden. A total of 220 patients and 1 close relative for each patient will participate. Neurocognitive function will be assessed preoperatively and at 1, 3 and 6 months postoperatively using a digitalised neurocognitive test battery. We will also evaluate postoperative patient-reported cognitive symptoms and signs, delirium, frailty, health-related quality of life, depression, perceived self-efficacy, fatigue and functional capacity. Each patient’s close relative will assess the observed cognitive function and report on caregiver burden. At the 6-month mark, a purposive sample of patients and their close relatives will be interviewed to explore their experiences of postoperative cognitive recovery.Ethics and dissemination The study has been approved by the Swedish Ethical Review Authority (Reference number: 2024-03380-01) and will adhere to the Helsinki Declaration and its amendments. The results will be disseminated through peer-reviewed journals and scientific conferences, as well as presented in various popular science forums and patient organisations.Trial registration number NCT06469515; Pre-results.
format Article
id doaj-art-25a15d76290f47509d67bf64ebcb2d6e
institution DOAJ
issn 2044-6055
language English
publishDate 2025-06-01
publisher BMJ Publishing Group
record_format Article
series BMJ Open
spelling doaj-art-25a15d76290f47509d67bf64ebcb2d6e2025-08-20T03:24:00ZengBMJ Publishing GroupBMJ Open2044-60552025-06-0115610.1136/bmjopen-2024-098208Exploring cognitive function and postoperative neurocognitive recovery after cardiac surgery in older adults (ECPON): a protocol for an observational studyUlrica Nilsson0Markus Saarijärvi1Lina Bergman2Jeanette Eckerblad3Gabriela Markovic4Ernad Zecevic5Tor Damén6Anna Martinik7Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, SwedenDepartment of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, SwedenDepartment of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, SwedenDepartment of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, SwedenDepartment of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, SwedenDepartment of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, SwedenDepartment of Anaesthesiology and Intensive Care Medicine, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenDepartment of Cardiothoracic Anaesthesia and Intensive Care, Sahlgrenska University Hospital, Gothenburg, SwedenIntroduction Cardiovascular disease is one of the most common health issues facing the older population, and the number of older adults undergoing cardiac surgery is expected to increase. Postoperative neurocognitive impairment is a frequent and often unrecognised complication that can adversely affect a patient’s recovery, quality of life and daily activities, as well as impact the lives of their family members. Patients may express cognitive difficulties as a feeling of ‘not being the same since the operation’. This study aims to investigate the factors that influence neurocognitive function and patient-reported cognitive symptoms among patients aged 65 and older following cardiac surgery, and explore the impact on the overall postoperative recovery. Additionally, the study aims to describe the perspectives of close relatives on the recovery process.Methods and analysis A longitudinal observational study with a mixed-methods approach will be conducted in two thoracic surgical departments in Sweden. A total of 220 patients and 1 close relative for each patient will participate. Neurocognitive function will be assessed preoperatively and at 1, 3 and 6 months postoperatively using a digitalised neurocognitive test battery. We will also evaluate postoperative patient-reported cognitive symptoms and signs, delirium, frailty, health-related quality of life, depression, perceived self-efficacy, fatigue and functional capacity. Each patient’s close relative will assess the observed cognitive function and report on caregiver burden. At the 6-month mark, a purposive sample of patients and their close relatives will be interviewed to explore their experiences of postoperative cognitive recovery.Ethics and dissemination The study has been approved by the Swedish Ethical Review Authority (Reference number: 2024-03380-01) and will adhere to the Helsinki Declaration and its amendments. The results will be disseminated through peer-reviewed journals and scientific conferences, as well as presented in various popular science forums and patient organisations.Trial registration number NCT06469515; Pre-results.https://bmjopen.bmj.com/content/15/6/e098208.full
spellingShingle Ulrica Nilsson
Markus Saarijärvi
Lina Bergman
Jeanette Eckerblad
Gabriela Markovic
Ernad Zecevic
Tor Damén
Anna Martinik
Exploring cognitive function and postoperative neurocognitive recovery after cardiac surgery in older adults (ECPON): a protocol for an observational study
BMJ Open
title Exploring cognitive function and postoperative neurocognitive recovery after cardiac surgery in older adults (ECPON): a protocol for an observational study
title_full Exploring cognitive function and postoperative neurocognitive recovery after cardiac surgery in older adults (ECPON): a protocol for an observational study
title_fullStr Exploring cognitive function and postoperative neurocognitive recovery after cardiac surgery in older adults (ECPON): a protocol for an observational study
title_full_unstemmed Exploring cognitive function and postoperative neurocognitive recovery after cardiac surgery in older adults (ECPON): a protocol for an observational study
title_short Exploring cognitive function and postoperative neurocognitive recovery after cardiac surgery in older adults (ECPON): a protocol for an observational study
title_sort exploring cognitive function and postoperative neurocognitive recovery after cardiac surgery in older adults ecpon a protocol for an observational study
url https://bmjopen.bmj.com/content/15/6/e098208.full
work_keys_str_mv AT ulricanilsson exploringcognitivefunctionandpostoperativeneurocognitiverecoveryaftercardiacsurgeryinolderadultsecponaprotocolforanobservationalstudy
AT markussaarijarvi exploringcognitivefunctionandpostoperativeneurocognitiverecoveryaftercardiacsurgeryinolderadultsecponaprotocolforanobservationalstudy
AT linabergman exploringcognitivefunctionandpostoperativeneurocognitiverecoveryaftercardiacsurgeryinolderadultsecponaprotocolforanobservationalstudy
AT jeanetteeckerblad exploringcognitivefunctionandpostoperativeneurocognitiverecoveryaftercardiacsurgeryinolderadultsecponaprotocolforanobservationalstudy
AT gabrielamarkovic exploringcognitivefunctionandpostoperativeneurocognitiverecoveryaftercardiacsurgeryinolderadultsecponaprotocolforanobservationalstudy
AT ernadzecevic exploringcognitivefunctionandpostoperativeneurocognitiverecoveryaftercardiacsurgeryinolderadultsecponaprotocolforanobservationalstudy
AT tordamen exploringcognitivefunctionandpostoperativeneurocognitiverecoveryaftercardiacsurgeryinolderadultsecponaprotocolforanobservationalstudy
AT annamartinik exploringcognitivefunctionandpostoperativeneurocognitiverecoveryaftercardiacsurgeryinolderadultsecponaprotocolforanobservationalstudy