Exploring variability in the causal link of HITS and cognitive decline.
Exploring variability in the causal link of HITS and cognitive decline.
复制标题
探索 HITS 与认知能力下降之间因果关系的变异性。
DOI：
10.1016/j.amjsurg.2008.11.018
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发表时间：
2009
影响因子：
3
通讯作者：
Crittenden,MichaelD
中科院分区：
文献类型：
--
作者：
Rudolph,JamesL;Martin,KristenK;Pochay,ValE;Crittenden,MichaelD
We thank Dr. Whitaker and associates for their comments and appreciate the opportunity to respond. The purpose of this study was to objectively review the evidence related to highintensity transient signals (HITS) and cognitive function after surgery. We agree with the biological plausibility where a microembolism occludes a small arteriole resulting in cognitive decline.[1] A causal link would establish definitively that increased microembolic load would result in a detectable cognitive decline. Table 1 reviews Hill's Criteria for causality as applied to HITS and cognitive function.[2] In our opinion, the literature to date does not establish a causal link.In agreement with Dr. Whitaker and associates, there is substantial variability in the studies presented. This variability limits the establishment of a causal link between HITS and cognitive decline after surgery. The variability limiting the causal link can be divided into five broad categories: 1) measurement of microemboli, 2) measurement of cognitive function, 3) patient factors, 4) operative, perioperative, and postoperative factors, and 5) study design. Each of these categories will be detailed below.
