Mini-cog performance: novel marker of post discharge risk among patients hospitalized for heart failure
Heart failure (HF) guidelines recommend screening for cognitive impairment (CI) but do not identify how. The Mini-Cog is an ultrashort cognitive "vital signs" measure that has not been studied in patients hospitalized for HF. The purpose of this study was to evaluate whether CI as assessed...
Gespeichert in:
| Veröffentlicht in: | Circulation. Heart failure 2015-01, Vol.8 (1), p.8-16 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 16 |
|---|---|
| container_issue | 1 |
| container_start_page | 8 |
| container_title | Circulation. Heart failure |
| container_volume | 8 |
| creator | Patel, Apurva Parikh, Roosha Howell, Erik H Hsich, Eileen Landers, Steven H Gorodeski, Eiran Z |
| description | Heart failure (HF) guidelines recommend screening for cognitive impairment (CI) but do not identify how. The Mini-Cog is an ultrashort cognitive "vital signs" measure that has not been studied in patients hospitalized for HF. The purpose of this study was to evaluate whether CI as assessed by the Mini-Cog is associated with increased readmission or mortality risk after hospitalization for HF.
We analyzed 720 consecutive patients who completed the Mini-Cog as a part of routine clinical care during hospitalization for HF. Our primary outcome was time between hospital discharge and first occurrence of readmission or mortality. There was a high prevalence of CI as quantified by Mini-Cog performance (23% of cohort). During a mean follow-up time of 6 months, 342 (48%) patients were readmitted, and 24 (3%) died. Poor Mini-Cog performance was an independent predictor of composite outcome (adjusted hazard ratio, 1.90; 95% confidence interval, 1.47-2.44; P |
| doi_str_mv | 10.1161/CIRCHEARTFAILURE.114.001438 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1652392233</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1652392233</sourcerecordid><originalsourceid>FETCH-LOGICAL-c321t-d605621cd1a6e01c16ef63b876bb84a86b9d2d23160ce859a5d2720f82b05b523</originalsourceid><addsrcrecordid>eNpdkE9Lw0AQxRdRbK1-BVnw4iV1_ySbRE8ltLZQEUp7DpvspF2bZONuKuind6Xag6cZhvfezPwQuqNkTKmgD9lilc2nk9V6NlksN6upn4ZjQmjIkzM0pGlIA87S-PzUJ-kAXTn3RohgUZReogGLwjgOOR2i7YtudVCaLe7AVsY2si3hEbfmA2rcSLsHi02FO-N6rLQrd9JuAVvt9lg2pvU22Wtoe4d3xnW6l7X-AoV9Et6BtD2upK4PFq7RRSVrBze_dYQ2s-k6mwfL1-dFNlkGJWe0D5QgkWC0VFQKILSkAirBiyQWRZGEMhFFqphinApSQhKlMlIsZqRKWEGiImJ8hO6PuZ017wdwfd74q6GuZQvm4HIqvChljHMvfTpKS2ucs1DlndX-5c-ckvyHdP6ftJ-G-ZG0d9_-LjoUDaiT9w8t_wZ8onzn</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1652392233</pqid></control><display><type>article</type><title>Mini-cog performance: novel marker of post discharge risk among patients hospitalized for heart failure</title><source>MEDLINE</source><source>American Heart Association</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Patel, Apurva ; Parikh, Roosha ; Howell, Erik H ; Hsich, Eileen ; Landers, Steven H ; Gorodeski, Eiran Z</creator><creatorcontrib>Patel, Apurva ; Parikh, Roosha ; Howell, Erik H ; Hsich, Eileen ; Landers, Steven H ; Gorodeski, Eiran Z</creatorcontrib><description>Heart failure (HF) guidelines recommend screening for cognitive impairment (CI) but do not identify how. The Mini-Cog is an ultrashort cognitive "vital signs" measure that has not been studied in patients hospitalized for HF. The purpose of this study was to evaluate whether CI as assessed by the Mini-Cog is associated with increased readmission or mortality risk after hospitalization for HF.
We analyzed 720 consecutive patients who completed the Mini-Cog as a part of routine clinical care during hospitalization for HF. Our primary outcome was time between hospital discharge and first occurrence of readmission or mortality. There was a high prevalence of CI as quantified by Mini-Cog performance (23% of cohort). During a mean follow-up time of 6 months, 342 (48%) patients were readmitted, and 24 (3%) died. Poor Mini-Cog performance was an independent predictor of composite outcome (adjusted hazard ratio, 1.90; 95% confidence interval, 1.47-2.44; P<0.0001) and was identified as the most important predictor among 55 variables by random survival forest analysis. Inclusion of Mini-Cog performance in risk models improved accuracy (bootstrapped c-index, 0.602 versus 0.624) and risk reclassification (category-free net reclassification improvement, 27%; 95% confidence interval, 14%-40%; P<0.001). Secondary analysis of initial 30 days post discharge showed effect modification by venue of discharge, whereby patients with CI discharged to a facility had longer time to outcome as compared with those discharged home.
Mini-Cog performance is a novel marker of posthospitalization risk. Discharge to facility rather than home may be protective for those patients with HF and CI. It is unknown whether structured in-home support would yield similar outcomes.</description><identifier>ISSN: 1941-3289</identifier><identifier>EISSN: 1941-3297</identifier><identifier>DOI: 10.1161/CIRCHEARTFAILURE.114.001438</identifier><identifier>PMID: 25477431</identifier><language>eng</language><publisher>United States</publisher><subject>Aged ; Aged, 80 and over ; Cognition - physiology ; Cognitive Dysfunction - epidemiology ; Cognitive Dysfunction - etiology ; Female ; Follow-Up Studies ; Heart Failure - complications ; Heart Failure - epidemiology ; Heart Failure - psychology ; Humans ; Incidence ; Inpatients ; Male ; Patient Discharge ; Prevalence ; Prognosis ; Prospective Studies ; Registries ; Risk Assessment - methods ; Risk Factors ; Survival Rate - trends ; United States - epidemiology</subject><ispartof>Circulation. Heart failure, 2015-01, Vol.8 (1), p.8-16</ispartof><rights>2014 American Heart Association, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c321t-d605621cd1a6e01c16ef63b876bb84a86b9d2d23160ce859a5d2720f82b05b523</citedby><cites>FETCH-LOGICAL-c321t-d605621cd1a6e01c16ef63b876bb84a86b9d2d23160ce859a5d2720f82b05b523</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3687,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25477431$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Patel, Apurva</creatorcontrib><creatorcontrib>Parikh, Roosha</creatorcontrib><creatorcontrib>Howell, Erik H</creatorcontrib><creatorcontrib>Hsich, Eileen</creatorcontrib><creatorcontrib>Landers, Steven H</creatorcontrib><creatorcontrib>Gorodeski, Eiran Z</creatorcontrib><title>Mini-cog performance: novel marker of post discharge risk among patients hospitalized for heart failure</title><title>Circulation. Heart failure</title><addtitle>Circ Heart Fail</addtitle><description>Heart failure (HF) guidelines recommend screening for cognitive impairment (CI) but do not identify how. The Mini-Cog is an ultrashort cognitive "vital signs" measure that has not been studied in patients hospitalized for HF. The purpose of this study was to evaluate whether CI as assessed by the Mini-Cog is associated with increased readmission or mortality risk after hospitalization for HF.
We analyzed 720 consecutive patients who completed the Mini-Cog as a part of routine clinical care during hospitalization for HF. Our primary outcome was time between hospital discharge and first occurrence of readmission or mortality. There was a high prevalence of CI as quantified by Mini-Cog performance (23% of cohort). During a mean follow-up time of 6 months, 342 (48%) patients were readmitted, and 24 (3%) died. Poor Mini-Cog performance was an independent predictor of composite outcome (adjusted hazard ratio, 1.90; 95% confidence interval, 1.47-2.44; P<0.0001) and was identified as the most important predictor among 55 variables by random survival forest analysis. Inclusion of Mini-Cog performance in risk models improved accuracy (bootstrapped c-index, 0.602 versus 0.624) and risk reclassification (category-free net reclassification improvement, 27%; 95% confidence interval, 14%-40%; P<0.001). Secondary analysis of initial 30 days post discharge showed effect modification by venue of discharge, whereby patients with CI discharged to a facility had longer time to outcome as compared with those discharged home.
Mini-Cog performance is a novel marker of posthospitalization risk. Discharge to facility rather than home may be protective for those patients with HF and CI. It is unknown whether structured in-home support would yield similar outcomes.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cognition - physiology</subject><subject>Cognitive Dysfunction - epidemiology</subject><subject>Cognitive Dysfunction - etiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Failure - complications</subject><subject>Heart Failure - epidemiology</subject><subject>Heart Failure - psychology</subject><subject>Humans</subject><subject>Incidence</subject><subject>Inpatients</subject><subject>Male</subject><subject>Patient Discharge</subject><subject>Prevalence</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Registries</subject><subject>Risk Assessment - methods</subject><subject>Risk Factors</subject><subject>Survival Rate - trends</subject><subject>United States - epidemiology</subject><issn>1941-3289</issn><issn>1941-3297</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkE9Lw0AQxRdRbK1-BVnw4iV1_ySbRE8ltLZQEUp7DpvspF2bZONuKuind6Xag6cZhvfezPwQuqNkTKmgD9lilc2nk9V6NlksN6upn4ZjQmjIkzM0pGlIA87S-PzUJ-kAXTn3RohgUZReogGLwjgOOR2i7YtudVCaLe7AVsY2si3hEbfmA2rcSLsHi02FO-N6rLQrd9JuAVvt9lg2pvU22Wtoe4d3xnW6l7X-AoV9Et6BtD2upK4PFq7RRSVrBze_dYQ2s-k6mwfL1-dFNlkGJWe0D5QgkWC0VFQKILSkAirBiyQWRZGEMhFFqphinApSQhKlMlIsZqRKWEGiImJ8hO6PuZ017wdwfd74q6GuZQvm4HIqvChljHMvfTpKS2ucs1DlndX-5c-ckvyHdP6ftJ-G-ZG0d9_-LjoUDaiT9w8t_wZ8onzn</recordid><startdate>201501</startdate><enddate>201501</enddate><creator>Patel, Apurva</creator><creator>Parikh, Roosha</creator><creator>Howell, Erik H</creator><creator>Hsich, Eileen</creator><creator>Landers, Steven H</creator><creator>Gorodeski, Eiran Z</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201501</creationdate><title>Mini-cog performance: novel marker of post discharge risk among patients hospitalized for heart failure</title><author>Patel, Apurva ; Parikh, Roosha ; Howell, Erik H ; Hsich, Eileen ; Landers, Steven H ; Gorodeski, Eiran Z</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c321t-d605621cd1a6e01c16ef63b876bb84a86b9d2d23160ce859a5d2720f82b05b523</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cognition - physiology</topic><topic>Cognitive Dysfunction - epidemiology</topic><topic>Cognitive Dysfunction - etiology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Failure - complications</topic><topic>Heart Failure - epidemiology</topic><topic>Heart Failure - psychology</topic><topic>Humans</topic><topic>Incidence</topic><topic>Inpatients</topic><topic>Male</topic><topic>Patient Discharge</topic><topic>Prevalence</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Registries</topic><topic>Risk Assessment - methods</topic><topic>Risk Factors</topic><topic>Survival Rate - trends</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Patel, Apurva</creatorcontrib><creatorcontrib>Parikh, Roosha</creatorcontrib><creatorcontrib>Howell, Erik H</creatorcontrib><creatorcontrib>Hsich, Eileen</creatorcontrib><creatorcontrib>Landers, Steven H</creatorcontrib><creatorcontrib>Gorodeski, Eiran Z</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation. Heart failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Patel, Apurva</au><au>Parikh, Roosha</au><au>Howell, Erik H</au><au>Hsich, Eileen</au><au>Landers, Steven H</au><au>Gorodeski, Eiran Z</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mini-cog performance: novel marker of post discharge risk among patients hospitalized for heart failure</atitle><jtitle>Circulation. Heart failure</jtitle><addtitle>Circ Heart Fail</addtitle><date>2015-01</date><risdate>2015</risdate><volume>8</volume><issue>1</issue><spage>8</spage><epage>16</epage><pages>8-16</pages><issn>1941-3289</issn><eissn>1941-3297</eissn><abstract>Heart failure (HF) guidelines recommend screening for cognitive impairment (CI) but do not identify how. The Mini-Cog is an ultrashort cognitive "vital signs" measure that has not been studied in patients hospitalized for HF. The purpose of this study was to evaluate whether CI as assessed by the Mini-Cog is associated with increased readmission or mortality risk after hospitalization for HF.
We analyzed 720 consecutive patients who completed the Mini-Cog as a part of routine clinical care during hospitalization for HF. Our primary outcome was time between hospital discharge and first occurrence of readmission or mortality. There was a high prevalence of CI as quantified by Mini-Cog performance (23% of cohort). During a mean follow-up time of 6 months, 342 (48%) patients were readmitted, and 24 (3%) died. Poor Mini-Cog performance was an independent predictor of composite outcome (adjusted hazard ratio, 1.90; 95% confidence interval, 1.47-2.44; P<0.0001) and was identified as the most important predictor among 55 variables by random survival forest analysis. Inclusion of Mini-Cog performance in risk models improved accuracy (bootstrapped c-index, 0.602 versus 0.624) and risk reclassification (category-free net reclassification improvement, 27%; 95% confidence interval, 14%-40%; P<0.001). Secondary analysis of initial 30 days post discharge showed effect modification by venue of discharge, whereby patients with CI discharged to a facility had longer time to outcome as compared with those discharged home.
Mini-Cog performance is a novel marker of posthospitalization risk. Discharge to facility rather than home may be protective for those patients with HF and CI. It is unknown whether structured in-home support would yield similar outcomes.</abstract><cop>United States</cop><pmid>25477431</pmid><doi>10.1161/CIRCHEARTFAILURE.114.001438</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1941-3289 |
| ispartof | Circulation. Heart failure, 2015-01, Vol.8 (1), p.8-16 |
| issn | 1941-3289 1941-3297 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1652392233 |
| source | MEDLINE; American Heart Association; EZB-FREE-00999 freely available EZB journals |
| subjects | Aged Aged, 80 and over Cognition - physiology Cognitive Dysfunction - epidemiology Cognitive Dysfunction - etiology Female Follow-Up Studies Heart Failure - complications Heart Failure - epidemiology Heart Failure - psychology Humans Incidence Inpatients Male Patient Discharge Prevalence Prognosis Prospective Studies Registries Risk Assessment - methods Risk Factors Survival Rate - trends United States - epidemiology |
| title | Mini-cog performance: novel marker of post discharge risk among patients hospitalized for heart failure |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T12%3A05%3A22IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Mini-cog%20performance:%20novel%20marker%20of%20post%20discharge%20risk%20among%20patients%20hospitalized%20for%20heart%20failure&rft.jtitle=Circulation.%20Heart%20failure&rft.au=Patel,%20Apurva&rft.date=2015-01&rft.volume=8&rft.issue=1&rft.spage=8&rft.epage=16&rft.pages=8-16&rft.issn=1941-3289&rft.eissn=1941-3297&rft_id=info:doi/10.1161/CIRCHEARTFAILURE.114.001438&rft_dat=%3Cproquest_cross%3E1652392233%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1652392233&rft_id=info:pmid/25477431&rfr_iscdi=true |