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Measurement of post-operative cognitive dysfunction after cardiac surgery: a systematic review
J L Rudolph1, K A Schreiber, D J Culley
1Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02130, USA. jrudolph@partners.org
Acta Anaesthesiologica Scandinavica
|April 20, 2010
Summary
Post-operative cognitive dysfunction (POCD) after cardiac surgery lacks consistent measurement and definition. This variability hinders research on POCD causes and treatments, impacting patient care.
Area of Science:
- Medical research
- Neuroscience
- Surgical outcomes
Background:
- Post-operative cognitive dysfunction (POCD) is a recognized complication following cardiac surgery.
- Existing research on POCD exhibits significant heterogeneity in its measurement and definition.
Purpose of the Study:
- To analyze the variability in the measurement and definitions of POCD.
- To evaluate current research against the 1995 Consensus Statement on POCD measurement.
Main Methods:
- Systematic literature search for studies on thoracic surgery and cognition.
- Review of English articles (>50 participants, post-1995) with pre- and post-operative psychometric testing.
- Data abstraction on POCD measurement and definition compared to consensus guidelines.
Main Results:
- Sixty-two studies were identified, but less than half used recommended neuropsychological tests.
- Attention and memory were frequently assessed; motor skills less so.
- Varied definitions of POCD (e.g., % decline, SD decline) and inconsistent assessment of anxiety, depression, and learning were noted.
Conclusions:
- Significant heterogeneity exists in POCD measurement and definition across studies.
- This variability impedes comparative analysis of POCD causes and treatments.
- Standardization is needed to advance POCD research and clinical understanding.
