Huynh, QL and Negishi, K and Blizzard, L and Saito, M and De Pasquale, CG and Hare, JL and Leung, D and Stanton, T and Sanderson, K and Venn, AJ and Marwick, TH, Mild cognitive impairment predicts death and readmission within 30 days of discharge for heart failure, International Journal of Cardiology, 221 pp. 212-217. ISSN 0167-5273 (2016) [Refereed Article]
Copyright 2016 Elsevier Ireland Ltd.
METHODS: This study followed 565 patients from an Australia-wide HF longitudinal study. Cognitive function (MoCA score) together with standard clinical and non-clinical factors, mental health and 2D echocardiograms were collected before hospital discharge. The study outcomes were death and readmission within 30days of discharge. Logistic regression, Harrell's C-statistic, integrated discrimination improvement (IDI) and net reclassification index were used for analysis.
RESULTS: Among 565 patients, 255 (45%) had at least mild cognitive impairment (MoCA≤22). Death (n=43, 8%) and readmission (n=122, 21%) within 30days of discharge were more likely to occur among patients with mild cognitive impairment (OR=2.00, p=0.001). MoCA score was also negatively associated with 30-day readmission or death (OR=0.91, p<0.001) independent of other risk factors. Adding MoCA score to an existing prediction model of 30-day readmission significantly improved discrimination (C-statistic=0.715 vs. 0.617, IDI estimate 0.077, p<0.001). From prediction models developed from our study, adding MoCA score (C-statistic=0.83) provided incremental value to that of standard clinical and non-clinical factors (C-statistic=0.76) and echocardiogram parameters (C-statistic=0.81) in predicting 30-day readmission or death. Reclassification analysis suggests that addition of MoCA score improved classification for a net of 12% of patients with 30-day readmission or death and of 6% of patients without (p=0.002).
CONCLUSIONS: Mild cognitive impairment predicts short-term outcomes in HF, independent of clinical and non-clinical factors.
|Item Type:||Refereed Article|
|Keywords:||Cognitive function, Depression, Heart failure, Mortality, Rehospitalization|
|Research Division:||Medical and Health Sciences|
|Research Group:||Cardiorespiratory Medicine and Haematology|
|Research Field:||Cardiology (incl. Cardiovascular Diseases)|
|Objective Group:||Clinical Health (Organs, Diseases and Abnormal Conditions)|
|Objective Field:||Cardiovascular System and Diseases|
|UTAS Author:||Huynh, QL (Dr Quan Huynh)|
|UTAS Author:||Negishi, K (Dr Kazuaki Negishi)|
|UTAS Author:||Blizzard, L (Professor Leigh Blizzard)|
|UTAS Author:||Saito, M (Dr Makoto Saito)|
|UTAS Author:||Sanderson, K (Associate Professor Kristy Sanderson)|
|UTAS Author:||Venn, AJ (Professor Alison Venn)|
|UTAS Author:||Marwick, TH (Professor Tom Marwick)|
|Web of Science® Times Cited:||22|
|Deposited By:||Menzies Institute for Medical Research|
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