Assessing postoperative cognitive change after cardiopulmonary bypass surgery

Cognitive decline after cardiopulmonary bypass (CPB) surgery has been a concern since the advent of CPB procedures. A primary focus of many studies on this topic has been to quantify the incidence of post-CPB cognitive impairment. However, studies that have used traditional parametric statistics have generally failed to confirm that long-lasting (greater than or equal to 1 month) cognitive declines occur reliably after CPB surgery. For the present study, the authors used a split-plot analysis of variance model that revealed preoperative memory impairments in the CPB patients and new postoperative impairments of attention. The authors discuss the assumptions of, and problems associated with, analysis methods that are often used to quantify the incidence of cognitive impairment following CPB surgery.