{"title":"时钟绘制试验对经导管主动脉瓣置入术后再入院患者术前认知功能障碍的筛查评估。","authors":"Tomoko Suyama, Shinobu Sugihara, Ryuji Suyama, Naoki Fukuyama, Naoki Suyama, Yuta Ito, Ryota Seto, Kaori Kinoshita, Shihori Kitae, Kinya Shirota","doi":"10.33160/yam.2023.08.003","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Transcatheter aortic valve implantation (TAVI) has recently become more common as a treatment for severe, symptomatic aortic stenosis (AS). Cognitive impairment (CI) is strongly associated with the prognosis of TAVI patients. However, some cognitive assessments currently in use are difficult to perform routinely in the clinical setting. To easier CI evaluation, we investigated whether CI using the clock-drawing test (CDT), one part of the Mini-Cog, affects the postoperative prognosis of TAVI patients with AS.</p><p><strong>Methods: </strong>The present study enrolled 52 patients (median age, 85 years; 28.8% male) who underwent TAVI and were discharged between 2019 and 2021. The outcome was readmission for all causes within one year of discharge and patients were grouped according to whether they were readmitted or not. Cognitive function was assessed using the Mini-Cog which combines verbal playback and CDT.</p><p><strong>Results: </strong>Of the 52, 11 patients (21.2%) comprised readmission group, including 4 (36.4%) each for fracture and infection, and 1 (9.1%) each for heart failure, subdural hematoma, and pneumothorax. Median Mini-Cog score was lower in the readmission group than in the non-readmission group (4 vs. 5; <i>P</i> < 0.05). The frequency of Mini-Cog score < 3 (indicative of CI) and CDT failure were significantly higher in the readmission group than in the non-readmission group, respectively (46% vs. 7%, <i>P</i> < 0.01) (46% vs. 12%, <i>P</i> < 0.05). Both of Mini-Cog score < 3 and CDT failure were independently associated with readmission. The areas under the curve showed CDT was an indicator of readmission with similar accuracy to the Mini-Cog score < 3. Kaplan-Meier curves showed significant differences in readmission after 1 year between the 2 Mini-Cog groups with scores of < 3 or ≥ 3 points and CDT failure and success.</p><p><strong>Conclusion: </strong>The CDT may be a very easy and simple screening assessment of preoperative CI with readmission within one year after TAVI.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"66 3","pages":"345-354"},"PeriodicalIF":0.9000,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10444581/pdf/yam-66-345.pdf","citationCount":"0","resultStr":"{\"title\":\"The Clock-Drawing Test as a Useful Screening Assessment of Preoperative Cognitive Impairment with Readmission After Transcatheter Aortic Valve Implantation.\",\"authors\":\"Tomoko Suyama, Shinobu Sugihara, Ryuji Suyama, Naoki Fukuyama, Naoki Suyama, Yuta Ito, Ryota Seto, Kaori Kinoshita, Shihori Kitae, Kinya Shirota\",\"doi\":\"10.33160/yam.2023.08.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Transcatheter aortic valve implantation (TAVI) has recently become more common as a treatment for severe, symptomatic aortic stenosis (AS). Cognitive impairment (CI) is strongly associated with the prognosis of TAVI patients. However, some cognitive assessments currently in use are difficult to perform routinely in the clinical setting. To easier CI evaluation, we investigated whether CI using the clock-drawing test (CDT), one part of the Mini-Cog, affects the postoperative prognosis of TAVI patients with AS.</p><p><strong>Methods: </strong>The present study enrolled 52 patients (median age, 85 years; 28.8% male) who underwent TAVI and were discharged between 2019 and 2021. The outcome was readmission for all causes within one year of discharge and patients were grouped according to whether they were readmitted or not. Cognitive function was assessed using the Mini-Cog which combines verbal playback and CDT.</p><p><strong>Results: </strong>Of the 52, 11 patients (21.2%) comprised readmission group, including 4 (36.4%) each for fracture and infection, and 1 (9.1%) each for heart failure, subdural hematoma, and pneumothorax. Median Mini-Cog score was lower in the readmission group than in the non-readmission group (4 vs. 5; <i>P</i> < 0.05). The frequency of Mini-Cog score < 3 (indicative of CI) and CDT failure were significantly higher in the readmission group than in the non-readmission group, respectively (46% vs. 7%, <i>P</i> < 0.01) (46% vs. 12%, <i>P</i> < 0.05). Both of Mini-Cog score < 3 and CDT failure were independently associated with readmission. The areas under the curve showed CDT was an indicator of readmission with similar accuracy to the Mini-Cog score < 3. Kaplan-Meier curves showed significant differences in readmission after 1 year between the 2 Mini-Cog groups with scores of < 3 or ≥ 3 points and CDT failure and success.</p><p><strong>Conclusion: </strong>The CDT may be a very easy and simple screening assessment of preoperative CI with readmission within one year after TAVI.</p>\",\"PeriodicalId\":23795,\"journal\":{\"name\":\"Yonago acta medica\",\"volume\":\"66 3\",\"pages\":\"345-354\"},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2023-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10444581/pdf/yam-66-345.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Yonago acta medica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.33160/yam.2023.08.003\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Yonago acta medica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.33160/yam.2023.08.003","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
The Clock-Drawing Test as a Useful Screening Assessment of Preoperative Cognitive Impairment with Readmission After Transcatheter Aortic Valve Implantation.
Background: Transcatheter aortic valve implantation (TAVI) has recently become more common as a treatment for severe, symptomatic aortic stenosis (AS). Cognitive impairment (CI) is strongly associated with the prognosis of TAVI patients. However, some cognitive assessments currently in use are difficult to perform routinely in the clinical setting. To easier CI evaluation, we investigated whether CI using the clock-drawing test (CDT), one part of the Mini-Cog, affects the postoperative prognosis of TAVI patients with AS.
Methods: The present study enrolled 52 patients (median age, 85 years; 28.8% male) who underwent TAVI and were discharged between 2019 and 2021. The outcome was readmission for all causes within one year of discharge and patients were grouped according to whether they were readmitted or not. Cognitive function was assessed using the Mini-Cog which combines verbal playback and CDT.
Results: Of the 52, 11 patients (21.2%) comprised readmission group, including 4 (36.4%) each for fracture and infection, and 1 (9.1%) each for heart failure, subdural hematoma, and pneumothorax. Median Mini-Cog score was lower in the readmission group than in the non-readmission group (4 vs. 5; P < 0.05). The frequency of Mini-Cog score < 3 (indicative of CI) and CDT failure were significantly higher in the readmission group than in the non-readmission group, respectively (46% vs. 7%, P < 0.01) (46% vs. 12%, P < 0.05). Both of Mini-Cog score < 3 and CDT failure were independently associated with readmission. The areas under the curve showed CDT was an indicator of readmission with similar accuracy to the Mini-Cog score < 3. Kaplan-Meier curves showed significant differences in readmission after 1 year between the 2 Mini-Cog groups with scores of < 3 or ≥ 3 points and CDT failure and success.
Conclusion: The CDT may be a very easy and simple screening assessment of preoperative CI with readmission within one year after TAVI.
期刊介绍：
Yonago Acta Medica (YAM) is an electronic journal specializing in medical sciences, published by Tottori University Medical Press, 86 Nishi-cho, Yonago 683-8503, Japan.
The subject areas cover the following: molecular/cell biology; biochemistry; basic medicine; clinical medicine; veterinary medicine; clinical nutrition and food sciences; medical engineering; nursing sciences; laboratory medicine; clinical psychology; medical education.
Basically, contributors are limited to members of Tottori University and Tottori University Hospital. Researchers outside the above-mentioned university community may also submit papers on the recommendation of a professor, an associate professor, or a junior associate professor at this university community.
Articles are classified into four categories: review articles, original articles, patient reports, and short communications.
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