Researchers from St Petersburg University have developed a software application that will evaluate the cognitive state of cardiac surgery patients and improve the efficiency of post-surgical treatment.
The programme was developed by the team which included: Professor Olga Shchelkova, the head of the Department of Medical Psychology and Psychophysiology at St Petersburg State University; Assistant Professor Daria Eremina, the research team manager; and Senior Researcher Associate Ivan Gorbunov.
The scientists said that the way the patient recovers after reconstructive heart surgery is of vital importance for clinical prediction. The intervention should result initially in a reduction of symptoms and an improvement of general state. Secondly, it is expected to lead to a return to normal life. However, doctors say that patients tend not to go to work after rehabilitation despite the absence of medical contraindications. Some of them appear again on the operating table in a year.
This is largely due to psychological factors, and the person’s emotional state and cognitive functioning, which is the process of rational cognition of the world and purposeful interaction with it. It significantly affects a patient’s quality of life and determines compliance – medication adherence and willingness to comply with the doctor’s instructions. ‘This involves not only taking medications, but also: a regimen of physical activity; tobacco and alcohol consumption; maintaining a healthy lifestyle; and dieting,’ explained Daria Eremina, the research team manager.
The development of a software application for predicting the state of a patient’s cognitive sphere after cardiac surgery was carried out as part of two grant projects: a grant from the Russian Foundation for Basic Research; and a grant from the President of the Russian Federation.
While developing the programme, the scientists ran diagnostic tests to monitor the condition of more than a hundred patients at the stage of preparation for surgery – coronary artery bypass surgery. Then they monitored their condition two weeks, three months, six months and a year after successful surgery. The data obtained were mathematically processed. The innovative software application is based on a system of many regression equations that predict certain parameters of cognitive functioning.
To perform calculations, it is necessary to download the pre-surgery results of the clinical and psychological examination and the social characteristics of the patient. The programme itself will build a predicted schedule of changes. It will show the most vulnerable areas of the patient’s cognitive functioning and give a forecast for ‘dangerous’ periods of critical cognitive decline.
The consulting physician, knowing this information, will be able to: timely recommend the patient to take nootropics or other drugs; as well as determine what psychological support the patient may need.
About 150 cardiosurgical patients have become study participants so far. Programme testing is under way at the Federal State Budgetary Institution ‘The Almazov National Medical Research Centre' of the Ministry of Health of Russia. According to Daria Eremina, it can be successfully used in clinical practice in all institutions that perform cardiac surgery.