Utility of Screening for Cognitive Impairment at Hospital Discharge in Adult Survivors of Critical Illness.
Gerardo Eman, Amber Marsh, Michelle Ng Gong and 1 others
PMID 35773197WHAT IT FOUND
Most ICU survivors could complete a phone cognitive screen at discharge, but those who could not were older, had more ventilator days, and had more daily-living impairments.
Lower screen scores were linked to new severe disability, not death.
Key findings
01Of the 320 survivors to hospital discharge, 213 completed a cognitive screen; 107 could not, and 47 of those were unable because of cognitive impairment.
02Survivors who could not complete the screen were older, had more ventilator days, and had more activity-of-daily-living impairments at discharge.
03Among those who completed the screen, a higher score was associated with lower risk of new severe disability at 6 months, but not with mortality.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This is a post hoc analysis of two observational cohorts, not a randomised trial or a tested intervention. No detailed assessment of delirium or coma was collected, so those important causes of cognitive impairment could not be adjusted for. The MoCA-Blind was not compared with other cognitive tests, and reliability was not measured in this study. The two cohorts used different methods to assess prehospital cognitive impairment, and the cohort itself was associated with MoCA scores. Many survivors could not complete the screen, so the completed assessments may represent patients who were healthier or more able to participate. The authors state the factors are descriptive and hypothesis-generating, not usable for clinical prediction. New severe disability was defined by ADL reports at baseline and 6 months, not by a detailed functional assessment.
The easy way to misread this
Do not treat a low MoCA score at discharge as a validated predictor of individual mortality or disability, or as proof that cognitive screening improves recovery. The study was observational, did not adjust for delirium or coma, and the authors describe the associations as hypothesis-generating rather than clinical prediction.