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TBI Test Identifies Those at Risk for Cognitive Decline After Surgery


 

Physicians can use the Paced Auditory Serial Addition Test (PASAT) to assess patients' cognitive decline after cardiac surgery, said Yolanda Carrascal, M.D., of the University of Valladolid (Spain) and her associates.

Postoperative cognitive deficits have been reported in up to 80% of such patients, most often after extracorporeal circulation. Typically, cognitive assessment requires a complex battery of tests that can be performed and interpreted only by experienced psychometricians. What is needed is a brief, simple test that can be administered by personnel not specifically trained in psychometrics, such as cardiac surgeons, the investigators said (Interact. Cardiovasc. Thorac. Surg. 2005;4:216–21).

They proposed that the PASAT fills that bill. The 2-minute test of simple addition has been used since the 1970s to assess neurologic deterioration after mild traumatic brain injury, and more recently has been used to track cognitive damage secondary to disorders such as multiple sclerosis.

The researchers administered the PASAT to 132 patients (mean age 67 years) before and after cardiac surgery involving extracorporeal circulation, and found that 60 (45.5%) had significant cognitive decline after the procedure. Half still had impairment 4 months later.

Mary Ann Moon

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