在冠状动脉旁路移植手术的随机对照试验的认知结果从2005年到2025年:一个系统的审查
Shantanu Srivatsa1, Sajeevan Sujanthan2, Sydni Paleczny3
1Department of Medicine University of North Carolina School of Medicine Chapel Hill North Carolina USA.
Journal of the American Heart Association
|January 14, 2026
概括
在冠状动脉旁路移植 (CABG) 手术后认知能力下降是常见的. 目前的CABG试验很少评估认知功能,现有的测试无法检测变化,强调需要更好的评估策略.
科学领域:
- 心脏病学 心脏病学
- 神经科学是一个神经科学.
- 临床试验 临床试验
背景情况:
- 认知能力下降是冠状动脉旁路移植 (CABG) 手术后经常出现的并发症.
- 这种下降显著影响患者的发病率,死亡率和整体生活质量.
- 需要对随机CABG试验对照组进行系统审查,以表征认知评估.
研究的目的:
- 系统地审查随机 CABG 试验对照组.
- 描述认知评估,测试频率,磨损和检测外科手术期间变化的能力.
- 在CABG研究中识别认知评估的差距.
主要方法:
- 从2005年1月到2025年2月,搜索了MEDLINE,Embase,Cochrane图书馆和PsycINFO的相关随机对照试验 (RCT).
- 包括仅接受CABG和客观认知评估的试验;不包括混合心脏手术或主观措施.
- 总结了任务频率,认知领域,消耗,并使用Cochrane风险偏差工具评估了偏差风险.
主要成果:
- 在2284项CABG试验中,只有71项 (3.1%) 报告了认知评估,涉及15925名患者.
- 步道制作测试B和A部分是最常用的认知任务.
- 在对照组中没有发现明显的术前和术后认知变化;平均消耗率为18.9%.
结论:
- 在CABG试验中,认知评估是罕见的,往往是不充分的.
- 通常使用的认知测试表明检测外科手术期间变化的能力有限.
- 高消耗率引发了对偏见的担忧;标准化,敏感的评估策略对于未来的CABG试验至关重要.
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