title: Report of the substudy assessing the impact of neurocognitive function on quality of life 5 years after cardiac surgery.
abstract: OBJECTIVE
  The importance of perioperative cognitive decline has long been debated. We recently demonstrated a significant correlation between perioperative cognitive decline and long-term cognitive dysfunction. Despite this association, some still question the importance of these changes in cognitive function to the quality of life of patients and their families. The purpose of our investigation was to determine the association between cognitive dysfunction and long-term quality of life after cardiac surgery.
  
  
  METHODS
  After institutional review board approval and patient informed consent, 261 patients undergoing cardiac surgery with cardiopulmonary bypass were enrolled and followed for 5 years. Cognitive function was measured with a battery of tests at baseline, discharge, and 6 weeks and 5 years postoperatively. Quality of life was assessed with well-validated, standardized assessments at the 5-year end point.
  
  
  RESULTS
  Our results demonstrate significant correlations between cognitive function and quality of life in patients after cardiac surgery. Lower 5-year overall cognitive function scores were associated with lower general health and a less productive working status. Multivariable logistic and linear regression controlling for age, sex, education, and diabetes confirmed this strong association in the majority of areas of quality of life.
  
  
  CONCLUSIONS
  Five years after cardiac surgery, there is a strong relationship between neurocognitive functioning and quality of life. This has important social and financial implications for preoperative evaluation and postoperative care of patients undergoing cardiac surgery.
authors.affiliation: Department of Anesthesiology, Division of Neurology, Duke University Medical Center, Durham, NC, USA. newma005@mc.duke.edu
authors.forename: M F
authors.initials: MF
authors.lastname: Newman
authors.forename: H P
authors.initials: HP
authors.lastname: Grocott
authors.forename: J P
authors.initials: JP
authors.lastname: Mathew
authors.forename: W D
authors.initials: WD
authors.lastname: White
authors.forename: K
authors.initials: K
authors.lastname: Landolfo
authors.forename: J G
authors.initials: JG
authors.lastname: Reves
authors.forename: D T
authors.initials: DT
authors.lastname: Laskowitz
authors.forename: D B
authors.initials: DB
authors.lastname: Mark
authors.forename: J A
authors.initials: JA
authors.lastname: Blumenthal
mesh_terms: D017677:Age Distribution; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D009657:North Carolina / Q000453:epidemiology; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology*; D011788:Quality of Life; D017678:Sex Distribution; D013995:Time