Neuropsychological Testing: Methodology, Interpretation and Outcomes

The outcome most dreaded by patient and surgeon alike is a brain dysfunction. Numerous surveys indicate most patients would prefer death to significant neurological impairment. Cardiac surgery currently enjoys a remarkable safety record in regard to a low death rate and major cerebral infarctions. However, neurobehavioral dysfunction, i.e. memory, coordination, and attention deficits, continues to be an area that is identified in the literature as a major negative outcome associated with cardiac surgery. If the cardiac surgical community is going to eliminate brain injury associated with interoperative methods and apparatus, then a sensitive, reproducible and quick assessment of brain function that can be reliably correlated with surgical interventions is a basic requirement. This paper discusses the experimental design, environmental and statistical concerns relative to selecting a battery of neurobehavioral assessment tools appropriate for cardiac surgery patients so, as a team, we can make a safe operation safer.