COGNITION AND QUALITY OF LIFE AFTER CARDIAC SURGERY

老年患者将越来越多地接受心脏手术， 一般老年心脏病患者人数增加 每年.年龄是手术风险增加的因素 冠状动脉旁路移植术后并发症 （CABG）手术，尤其是中枢神经系统并发症。 老年患者似乎特别容易发生 术后出现认知和神经心理功能障碍 发生这种情况的机制尚不清楚。我们建议评估 术后认知和神经心理的影响 功能障碍对心脏病患者短期和长期生活质量的影响 手术病人神经心理疾病的发生率和严重程度 功能障碍将通过神经学和心理测量学测试来确定 100例冠状动脉旁路移植术患者，对照组50例 血管成形术患者作为生活质量变化的参考 疾病状态的改善。认知的持续时间 功能障碍将通过系列测试来确定。全面 将在当天进行神经心理测试 术前、CABG术后6周和6个月。广泛的性质 旨在评估通用和疾病的各个方面 将在同一测试中管理特定的生活质量 时期同步评估将使我们能够确定认知 下降及其与生活质量变化的关系。 体外循环（CPB）是研究心肌缺血的良好模型。 神经心理功能障碍，因为相对较高的发病率， 事件可以预期。这一过程中产生的新知识 研究可以更好地理解认知 心脏手术后的生活质量下降及其重要性 在老年人中。这些数据将使我们首次能够 确定进行潜在药理学研究的重要性， 温度或CPB技术干预， 老年人心脏手术后的神经心理缺陷。

Elderly patients will increasingly undergo cardiac surgery as the general population of elderly patients with heart disease increases each year. Age is an incremental risk factor for surgical complications in patients who have coronary artery bypass graft (CABG) surgery, especially central nervous system complications. Elderly patients appear to be especially at increased risk of suffering cognitive and neuropsychologic dysfunction postoperatively. The mechanism by which this occurs is not known. We propose to assess the impact of postoperative cognitive and neuropsychologic dysfunction on short and long-term quality of life in cardiac surgical patients. The incidence and severity of neuropsychologic dysfunction will be determined by neurologic and psychometric testing in 100 CABG patients over one year, with a control group of 50 angioplasty patients used as a reference of change in quality of life with improvement in disease state. The duration of cognitive dysfunction will be determined by serial testing. A comprehensive neuropsychological test battery will be administered on the day before surgery, 6 weeks and 6 months post-CABG. An extensive quality of life battery designed to assess aspects of generic and disease specific quality of life will be administered at the same testing periods. Simultaneous assessment will allow us to determine cognitive decline and its association with changes in quality of life. Cardiopulmonary bypass (CPB) is an excellent model for the study of neuropsychologic dysfunction since a relatively high incidence of events can be expected. The new knowledge generated in this investigation could lead to a better understanding of cognitive decline and its importance to quality of life after cardiac surgery in the elderly. This data will allow us for the first time to determine the importance of proceeding with potential pharmacologic, temperature or CPB technology interventions to reduce neuropsychologic deficits after cardiac surgery in the elderly.