5, 11, 12 The reasons for this are unclear but may be partially clear because of variety of different screening tools used. 8 Although CI has been consistently related to increased mortality risk in inpatients 9 and outpatients with HF, 10 its reported association with readmission risk in HF has been mixed. 1 CI can be caused or worsened by environmental factors, pharmacological factors, and delirium.ĬI is highly prevalent among patients with heart failure (HF) 2 – 5 and has been associated with poorer medication adherence 2 and overall treatment adherence, 6 reduced instrumental activities of daily living, 7 and worse self-care. The severity of dementia-related CI ranges from mild to severe. Although the most well-known form of CI is Alzheimer disease, it is associated with other types of dementia diagnoses as well. 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.Ĭognitive impairment (CI) is an inclusive term to describe trouble with memory, learning, concentration, or decision making. 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). 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. During a mean follow-up time of 6 months, 342 (48%) patients were readmitted, and 24 (3%) died. There was a high prevalence of CI as quantified by Mini-Cog performance (23% of cohort). Our primary outcome was time between hospital discharge and first occurrence of readmission or mortality. We analyzed 720 consecutive patients who completed the Mini-Cog as a part of routine clinical care during hospitalization for HF.
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