title: Neurocognitive outcomes after cardiac surgery.
abstract: OBJECTIVE
  To summarize recent studies of neurocognitive dysfunction after cardiac surgery, as well as to outline efforts and approaches toward advancing the field.
  
  
  RESULTS
  Observational studies have improved our understanding of the incidence and the trajectory of cognitive decline after cardiac surgery; however, the magnitude of this neurocognitive change remains controversial because of the inconsistent definitions and the lack of a gold-standard diagnostic modality. Nonetheless, physicians commonly see patients with functional and cognitive impairments after cardiac surgery, which utilize healthcare resources and impact quality of life. Novel approaches have utilized advanced neuroimaging techniques as well as innovative monitoring modalities to improve the efficiency of neuroprotective strategies during cardiac surgery.
  
  
  CONCLUSIONS
  Adverse cognitive and neurologic outcomes following cardiac surgery range from discrete neurocognitive deficits to severe neurologic injury such as stroke and even death. The elderly are at higher risk of suffering these outcomes and the public health dimension of this problem is expected to accelerate. Future studies should combine advanced neuroimaging with genomic, transcriptional, proteomic, and metabolomic profiling to improve our understanding of the pathophysiologic mechanisms and optimize the diagnosis, prevention, and treatment of neurocognitive injury.
authors.affiliation: Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina 27110, USA. karsten.bartels@duke.edu
authors.forename: Karsten
authors.initials: K
authors.lastname: Bartels
authors.forename: David L
authors.initials: DL
authors.lastname: McDonagh
authors.forename: Mark F
authors.initials: MF
authors.lastname: Newman
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Mathew
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D012307:Risk Factors