Statement of consensus on assessment of neurobehavioral outcomes after cardiac surgery

Murkin, John M.; Newman, Stanton; Stump, David A.; Blumenthal, James A.

doi:10.1016/0003-4975(95)00106-u

Cited by 581 publications

(423 citation statements)

References 0 publications

Supporting

Mentioning

403

Contrasting

Unclassified

Order By: Relevance

“…[47][48][49][50][51] Assessment of cognitive recovery has thus progressed from simple assessments of orientation and comprehension 38,41,46 to more formal neuropsychological-based assessment. 26,37,52,53 More recent clinical recovery assessment tools, such as the Postoperative Quality of Recovery Scale (PostopQRS), 37 assess cognitive recovery by applying formal neuropsychological tests in truncated form and assessing patient recovery in relation to individual baseline function both in real time and over multiple time points.…”

Section: Measurement Of Recoverymentioning

confidence: 99%

The importance of postoperative quality of recovery: influences, assessment, and clinical and prognostic implications

Bowyer

Royse

2015

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Quality of recovery is a complex construct whose definition is influenced heavily by the opinions and biases of the individual patient, clinician, or institution. As a result, recovery assessment tools differ in their fundamental definitions of recovery, breadth, and assessment time frame. Accurate assessment of recovery is essential as suboptimal recovery has both economic and prognostic implications. Quality of care is often substituted as a surrogate at the institutional level for quality of recovery, but it is ideologically distinct from patients' perceived quality of care, recovery, and satisfaction. Recovery tools also differ in their assessment of recovery as a continuous vs dichotomous variable and in their focus at the group vs individual level. Ideally, recovery measures should assess outcomes in a simple dichotomous fashion and maintain relevancy by assessing in multiple domains at various time points. Assessment of recovery in a dichotomous fashion also has both clinical and research applications. It allows identification of suboptimal recovery at both individual and group levels, respectively, and when performed in real time, it allows the opportunity for timely targeted intervention specific to individual patients as well as for resource rationalization.Résumé La qualité de récupération est un construit complexe dont la définition est fortement influencée par les opinions et les biais du patient, du clinicien, voire de l'établissement. Dès lors, les outils d'évaluation de la récupération diffèrent de par la définition-même de la récupération, leur envergure, et le cadre temporel de l'évaluation. Une évaluation précise de la récupération est essentielle; en effet, une récupération sous-optimale a des implications tant économiques que pronostiques. Au niveau institutionnel, on utilise souvent la qualité des soins comme substitut de la qualité de récupération mais, d'un point de vue idéologique, ce concept se distingue de la qualité des soins, de la récupération et de la satisfaction telles que perçues par les patients. Les outils de récupération diffèrent également dans leur évaluation de la récupération en tant que variable continue ou dichotomique et dans leur emphase sur le groupe ou l'individu. Dans l'idéal, les mesures de la récupération devraient évaluer les pronostics de manière dichotomique simple et maintenir leur pertinence en évaluant plusieurs domaines à différents moments dans le temps. L'évaluation dichotomique de la récupération a également des applications cliniques et en recherche. Elle permet d'identifier une récupération sous-optimale tant au niveau du groupe que de l'individu. D'autre part, lorsque ce type d'évaluation est réalisé en temps réel, elle nous donne la possibilité d'intervenir d'une manière ciblée et opportune spécifique à chaque patient tout en rationnalisant les ressources.Author contributions Andrea Bowyer and Colin Royse contributed substantially to the conception and design of the manuscript and drafted the version to be published.

show abstract

Section: Measurement Of Recoverymentioning

confidence: 99%

The importance of postoperative quality of recovery: influences, assessment, and clinical and prognostic implications

Bowyer

Royse

2015

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

“…These tests are representative of the outcome measures recommended by a consensus group [19] along with tests used in previous studies of neuropsychological testing after carotid endarterectomy to better elucidate neurocognitive changes [1,13]. The Boston Naming Test evaluated patients' ability to verbally identify objects pictured on a series of cards.…”

Section: Neuropsychological Evaluationmentioning

confidence: 99%

Elevation of monocyte chemoattractant protein-1 in patients experiencing neurocognitive decline following carotid endarterectomy

Mack¹,

Ducruet²,

Hickman³

et al. 2008

Acta Neurochir (Wien)

View full text Add to dashboard Cite

SummaryBackground-Previous studies have demonstrated that elevated pre-operative monocyte count is an independent predictor of acute neurocognitive decline following carotid endarterectomy (CEA). Monocyte chemoattractant protein-1 (MCP-1), secreted by human endothelial and monocyte-like cells, is a potent mediator of inflammation and mononuclear cell trafficking. This study examines the relationship between peri-operative serum MCP-1 elevation and post-operative neurocognitive injury following CEA.

show abstract

“…It consists of four subtests: aural-oral subtest, visual-oral subtest, aural written subtest, and visual written subtest. With regard to the statement of consensus 8 on the assessment of neurobehavioural outcomes after cardiac surgery, the neuropsychiatric test battery should have its sensitivity and reliability confirmed in specific populations. The sensitivity and reliability of the MMSET and VADST have been established in a Turkish population.…”

Section: Ficativement éLevés Dans Le Groupe P De Notre éTude Aucunementioning

confidence: 99%

Propofol offers no advantage over isoflurane anesthesia for cerebral protection during cardiopulmonary bypass: a preliminary study of S-100ß protein levels

Kanbak

Saricaoglu

Avci

et al. 2004

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

P Pu ur rp po os se e: : Despite advances in anesthesia, cardiopulmonary bypass (CPB) and surgical techniques, cerebral injury remains a major source of morbidity after cardiac surgery. We compared the effects of two different anesthetic techniques, isoflurane vs propofol on neurological outcome by serum S-100ß protein and neuropsychological tests after coronary artery bypass grafting (CABG).M Me et th ho od ds s: : Twenty patients undergoing CABG, randomly allocated into two groups, were enrolled in this prospective, controlled, preliminary study. Isoflurane was used in group I and propofol in group P. Neurological examination and a neuropsychologic test battery consisting of the mini mental state examination (MMSET) and the visual aural digit span test (VADST) were obtained preoperatively and on the third and sixth postoperative days. Blood samples for analysis of S-100ß protein were collected before anesthesia (T1), after heparinization (T2), 15 min into CPB (T3), after CPB (T4) and at the 24 th hr postoperatively (T5).R Re es su ul lt ts s: : Postoperative neurological examinations of the patients were normal. VADST performance declined significantly on the third day (P < 0.05) in both groups, and there were no significant differences on VADST and MMSET scores between the two groups. In group P, S-100ß protein levels increased significantly at T3 and T4 compared to preoperative and isoflurane levels (P < 0.05).C Co on nc cl lu us si io on ns s: : Despite reports about the neuroprotective effects of propofol, S-100ß protein levels were significantly elevated in group P. Although there was no deterioration in neuropsychological outcome, propofol appeared to offer no advantage over isoflurane for cerebral protection during CPB in this preliminary study of 20 patients. C Ca ar rd di io ot th ho or ra ac ci ic c A An ne es st th he es si ia a, , R Re es sp pi ir ra at ti io on n a an nd d A Ai ir rw wa ay y Propofol offers no advantage over isoflurane anesthesia for cerebral protection during cardiopulmonary bypass: a preliminary study of S-100ß protein levels [L'anesthésie au propofol, comparé à l'isoflurane, n'a Objectif : Malgré les progrès de l'anesthésie, la circulation extracorporelle (CEC) et les techniques chirurgicales, les lésions cérébrales demeurent une importante source de morbidité postchirurgie cardiaque. Les effets neurologiques comparés de l'isoflurane et du propofol sont présentés par l'analyse des protéines sériques S-100ß et des test neuropsychologiques après un pontage aortocoronarien (PAC). Méthode : Notre étude préliminaire, prospective et contrôlée a porté sur 20 patients, répartis au hasard en deux groupes, qui devaient subir un PAC. L'isoflurane a été utilisé dans le groupe I et le propofol dans le groupe P. L'examen neurologique et une batterie de tests neuropsychologiques, comprenant le mini-examen de l'état mental (MMSET pour mini mental state examination) et le test visuel et auditif de mémoire des chiffres (VADST pour visual aural digit span test), ont été réalisés avant l'opérat...

show abstract

Statement of consensus on assessment of neurobehavioral outcomes after cardiac surgery

Cited by 581 publications

References 0 publications

The importance of postoperative quality of recovery: influences, assessment, and clinical and prognostic implications

The importance of postoperative quality of recovery: influences, assessment, and clinical and prognostic implications

Elevation of monocyte chemoattractant protein-1 in patients experiencing neurocognitive decline following carotid endarterectomy

Propofol offers no advantage over isoflurane anesthesia for cerebral protection during cardiopulmonary bypass: a preliminary study of S-100ß protein levels

Contact Info

Product

Resources

About